Management of SLE

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