Difference between revisions of "Systemic lupus erythematosus"

Line 1: Line 1:
 
==Background==
 
==Background==
*Autoimmune disorder affecting all sysems
+
*Autoimmune disorder affecting all systems
  
 
==Epidemiology==
 
==Epidemiology==
*Femaile:Male 10:1
+
*Female:Male 10:1
 
*More common in African Americans
 
*More common in African Americans
  
Line 31: Line 31:
 
***Cover for ''[[Listeria]]'' and ''[[Pseudmonas]]''
 
***Cover for ''[[Listeria]]'' and ''[[Pseudmonas]]''
 
**CAD
 
**CAD
 +
***More common and more complications post-PCI
 
**[[PE]]
 
**[[PE]]
 
**[[Pericarditis]]
 
**[[Pericarditis]]
Line 41: Line 42:
 
**[[Stroke]]
 
**[[Stroke]]
 
**[[Encephalitis]]
 
**[[Encephalitis]]
 +
**[[Meningitis]]
  
 
*Musculoskeletal
 
*Musculoskeletal
Line 82: Line 84:
 
==Management==
 
==Management==
 
*Steroids
 
*Steroids
 
+
**Stress-dose steroids if on or recently on chronic steroids
  
  
 
==Disposition==
 
==Disposition==
 
+
*Suspected new diagnosis can have out patient workup if well appearing
  
  

Revision as of 22:31, 25 March 2014

Background

  • Autoimmune disorder affecting all systems

Epidemiology

  • Female:Male 10:1
  • More common in African Americans


Clinical Features

Diagnostic Criteria: 4 out of 11 of the following:

  1. Malar rash
  2. Discoid rash
  3. Photosensitivity
  4. Oral ulcers
  5. Arthritis (polyarticular)
  6. Serositis (Pericarditis or pleuritis)
  7. Renal disorder (renal failure, protenuria, casts)
  8. Neurologic or psychotic symptoms
  9. Hematologic (anemia, thrombocytopenia, or leukopenia)
  10. Immunologic (+antibofy testing)
  11. ANA (positive ANA)

New Presentations


Flairs

  • Musculoskeletal
    • Arthritis
      • Usually symmetric
      • Consider septic arthritis if there is a single inflamed joint

Differential Diagnosis

Workup

Undiagnosed

  • CBC
  • Chem 10
  • ANA
  • ESR
  • UA
  • Bedside echo if ill or hypotensive

Flair

  • Bedside echo if ill or hypotensive
  • CBC



Management

  • Steroids
    • Stress-dose steroids if on or recently on chronic steroids


Disposition

  • Suspected new diagnosis can have out patient workup if well appearing


See Also

Sources

  • Rosen's
  • Up to date