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Management of SLE

Dr Swapnil Pawar December 8, 2020 154


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    Management of SLE
    Dr Swapnil Pawar

Diagnostic Criteria for Lupus: MD SOAP BRAIN

M – Malar Rash
D – Discoid Rash

S – Serositis (Pleurisy, Pericarditis)
O – Oral Ulcers
A – Arthritis (Symmetrical polyarthritis, non-erosive)
P – Photosensitivity

B – Bloods (Pancytopenia)
R – Renal (Lupus Nephritis)
A – ANA (elevated
I – Immunological (dsDNA, anti-Smith, anti-Histone)
N – Neurological (Seizures, psychosis)

Radiological Findings of Lupus-Associated Arthritis

  • Peri-Articular Osteopenia
    • Deformities (Jaccoud’s Arthropathy – reversible)
    • Subluxation/Dislocation
    • Bilateral and symmetrical distribution of changes
  • NO erosions
  • NO soft tissue calcifications

Anti-Phospholipid Syndrome

A venous and arterial thrombotic disorder associated with lupus that develops due to an autoimmune reaction to the phospholipids on cell membranes. It’s characterised by the acronym CLOT:

C – Coagulation Defect (Elevated APTT)
L – Livedo Reticularis
O – Obstetric complications (i.e. miscarriage)
T – Thrombocytopenia

Diagnosis is made clinically and through the presence of antiphospholipid antibodies:
– Lupus Anticoagulant
– Anti-Cardiolipin
– Anti-Beta 2 GP1

 

References: 

Erkan, D., Ortel, T.L. (2020). Diagnosis of Antiphospholipid Syndrome. UpToDate. Retrieved November 11, 2020, from https://www.uptodate.com.acs.hcn.com.au/contents/diagnosis-of-antiphospholipid-syndrome

Morgan, M.A. (2020). Lupus Arthropathy in the Hands and Wrists. Retrieved 7 November 2020, from https://radiopaedia.org/cases/lupus-arthropathy-in-the-hands-and-wrists

Wallace, D.J., Gladman, D.D. (2020). Clinical Manifestations and Diagnosis of Systemic Lupus Erythematosus in Adults. UpToDate. Retrieved November 11, 2020, from https://www.uptodate.com.acs.hcn.com.au/contents/clinical-manifestations-and-diagnosis-of-systemic-lupus-erythematosus-in-adults

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Management of Hyperthyroidism

Dr Swapnil Pawar November 30, 2020

Post was written by – Dr Hyerim Su   References  Campbell K., Doogue M., (2012) Evaluating and managing patients with thyrotoxicosis, AFP Volume 41 No. 8  

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