Difference between revisions of "Systemic lupus erythematosus"
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===Criteria=== | ===Criteria=== | ||
Mnemonic ''DAMP AS RHINO'':<ref>URL: [http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy]. Accessed on: 11 September 2011.</ref> | Mnemonic ''DAMP AS RHINO'':<ref>URL: [http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy]. Accessed on: 11 September 2011.</ref> | ||
* | *'''D'''iscoid rash. | ||
* | *'''A'''NA +ve | ||
* | **[[Sensitivity]] ~99%;<ref>{{Cite journal | last1 = Edworthy | first1 = SM. | last2 = Zatarain | first2 = E. | last3 = McShane | first3 = DJ. | last4 = Bloch | first4 = DA. | title = Analysis of the 1982 ARA lupus criteria data set by recursive partitioning methodology: new insights into the relative merit of individual criteria. | journal = J Rheumatol | volume = 15 | issue = 10 | pages = 1493-8 | month = Oct | year = 1988 | doi = | PMID = 3060613 }}</ref> negative finding essential excludes the diagnosis. | ||
* | *'''M'''alar rash. | ||
* | *'''P'''hotosensitive. | ||
* | *'''A'''rthritis. | ||
* | *'''S'''erositis (pericardial or pleural). | ||
* | *'''R'''enal dysfunction. | ||
* | **Proteinuria (>0.5 g/day) or cellular casts. | ||
**Anti-Smith antibody. | *'''H'''ematologic abnormality. | ||
* | **Includes: [[anemia]], leukopenia, lymphopenia, thrombocytopenia, hypocomplementemia (low C3 & C4). | ||
* | *'''I'''mmunologic abnormality. | ||
**Anti-Smith antibody, [[APLA]], VDRL false positive (test for [[syphilis]]). | |||
*'''N'''eurologic abnormality, e.g. seizures, psychosis. | |||
*'''O'''ral ulcer or nasal ulcer. | |||
===Prognosis=== | ===Prognosis=== | ||
Revision as of 16:56, 4 December 2011
Systemic lupus erythematosus, abbreviated SLE, is a common autoimmune disorder that typically affects multiple organs.
Diagnosis
The diagnosis rests on the evaluation of eleven clinical/laboratory criteria; if four of the eleven criteria are present, the diagnosis is made.[1]
Criteria
Mnemonic DAMP AS RHINO:[2]
- Discoid rash.
- ANA +ve
- Sensitivity ~99%;[3] negative finding essential excludes the diagnosis.
- Malar rash.
- Photosensitive.
- Arthritis.
- Serositis (pericardial or pleural).
- Renal dysfunction.
- Proteinuria (>0.5 g/day) or cellular casts.
- Hematologic abnormality.
- Includes: anemia, leukopenia, lymphopenia, thrombocytopenia, hypocomplementemia (low C3 & C4).
- Immunologic abnormality.
- Neurologic abnormality, e.g. seizures, psychosis.
- Oral ulcer or nasal ulcer.
Prognosis
Survival:[4]
- ~90% @ 10 years.
Mortality (leading causes):[4]
- Active SLE - esp. kidney involvement.
- Infections.
- Thrombosis.
Lymph node pathology
Skin
Pancreas
Kidney disease
Main article: Medical_kidney_diseases#Lupus_nephritis
References
- ↑ Gill, JM.; Quisel, AM.; Rocca, PV.; Walters, DT. (Dec 2003). "Diagnosis of systemic lupus erythematosus.". Am Fam Physician 68 (11): 2179-86. PMID 14677663.
- ↑ URL: http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy. Accessed on: 11 September 2011.
- ↑ Edworthy, SM.; Zatarain, E.; McShane, DJ.; Bloch, DA. (Oct 1988). "Analysis of the 1982 ARA lupus criteria data set by recursive partitioning methodology: new insights into the relative merit of individual criteria.". J Rheumatol 15 (10): 1493-8. PMID 3060613.
- ↑ 4.0 4.1 Madhok, R.; Wu, O. (Nov 2007). "Systemic lupus erythematosus.". Am Fam Physician 76 (9): 1351-3. PMID 18019880.