Condition Info - BotMed Application

ConditionName

Systemic lupus erythematosus (SLE)

ConditionDescription

Symptoms

Great imitator! Fever; Malaise; Joint pain; Myalgia; Fatigue;
Chronic; inflammatory; small joints; symmetrical;
Dermatological: photosensitivity rash; oral ulcers; UV light cause flares;
MSK: arthritis (symmetrical);
Neurologic: seizures, psychosis;
Hematologic: hemolytic anemia;
Serositis (pleuritis or pericarditis);
Renal involvement;

PhysicalFindings

ClinicalTests

(+)ANA – not specific, but negative test r/o lupus;

Specific: (+)anti-dsDNA – 60%; (+)Anti-Smith;

(Associated with anti-histone AB) – drug induced lupus;
R/O syphilis: lupus causes false positive RPR and VDRL tests;

CBC: Hemolytic anemia, lymphopenia, leukopenia, thrombocytopenia;

Decreased C3 and C4;

KI biopsy for severity of lupus nephritis;

RiskFactors

Female;
Ages 14-45;
Blacks;
Asians;
Latinas; 
Female (90%);

Drugs causing Lupus:
SHIPP;
Hydralazine;
Isoniazid;
Phenytoin;
Procainamide;
(Associated with anti-histone AB) – drug induced lupus;
Minocycline;
Statis;
Adalimumab;
Infliximab;
SMX-TMP (Sulfonamides);

Herbs associated with lupus-like flares:
Echinacea
Spirulina
Alfalfa tablets
Garlic

IsRedFlag

IsNPLEX

Consequence

Young: die from infection;
Older from MI associated with atherosclerosis, kidney function, brain;
Secondary Raynaud Syndrome;

ProgressionFromCondition

Drugs causing Lupus:
SHIPP;
Sulfonamides;
Hydralazine;
Isoniazid;
Phenytoin;
Procainamide;
(Associated with anti-histone AB) – drug induced lupus;

TreatmentOptions

Avoid the sun exposure: UV light cause flares.
Sunglasses;
Protective clothes;

PharmOptions

Steroids – for acute phase;

Hydroxychloroquine – control mild chronic dz;

NSAIDs;

Anticoagulants;

Drug induced: stop medication!

WebLink

https://www.merckmanuals.com/en-ca/professional/musculoskeletal-and-connective-tissue-disorders/autoimmune-rheumatic-disorders/systemic-lupus-erythematosus-sle