Systemic lupus erythematosus SLE

• Facts:
  Chronic, inflammatory autoimmune disorder
  Antibody mediated cellular attack and deposition of antigen-antibody complexes
  
• History / PE:
  Nonspecific symptoms (fever, anorexia, weight loss)
  Painless oral ulcers
  See DOPAMINE RASH
  
• Diagnosis:
  Anti-dsDNA antibodies
  Anti-Sm antibodies
  Antihistone antibodies (drug induced SLE)
  Anti-Ro antibodies (neonatal SLE)
  Pancytopenia
• Treatment:
  1) Need to perform kidney biopsy (baseline histology)
  2) NSAIDs (joint pain)
  3) Steroids (acute exacerbations)
• Complications:
  Lupus nephritis (major cause of M/M)
• Pneumonic:
  DOPAMINE RASH
  
  D iscoid rash
  O ral ulcers
  P hotosensitivity
  A rthritis
  M alar rash
  I mmunologic criteria
  N eurologic (lupus cerebritis, seizures)
  E levated ESR
  
  R enal disease
  A NA positive
  S erositis (pleural/ pericardial effusion )
  H ematologic abnormalities (anti-phospholipid antibody)
• Notes:
  Pancytopenia (decreased RBCs, WBCs, and platelets) occurs due to the formation of antibodies against blood cells, a form of type 2 hypersensitivity reaction (similar mechanism to that of idiopathic thrombocytopenic purpura )
• Associated With:
  Libman-Sacks Endocarditis
  Drugs (chlorpromazine, hydralazine, INH, methyldopa, penicillamine, procainamide, and quinidine)
  
• Differential Diagnosis:
  Mixed connective tissue disease (anti nRNP)