Difference between revisions of "Systemic lupus erythematosus"

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***Consider septic arthritis if there is a single inflamed joint
 
***Consider septic arthritis if there is a single inflamed joint
 
****Cover for [[''Salmonella'']] in addition to standard coverage
 
****Cover for [[''Salmonella'']] in addition to standard coverage
 +
 +
*GI
 +
**Lupus enteritis (mesenteric vasculitis)
 +
***Most common cause of acute abdominal pain
 +
**Pancreatitis
 +
**PUD
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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*Steroids
 
*Steroids
 
**Stress-dose steroids if on or recently on chronic steroids
 
**Stress-dose steroids if on or recently on chronic steroids
 +
**Inflammatory conditions: methylprednisolone 1-2mg/kg
 +
***Pericarditis
 +
***Lupus enteritis
  
  

Revision as of 22:41, 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
  • GI
    • Lupus enteritis (mesenteric vasculitis)
      • Most common cause of acute abdominal pain
    • Pancreatitis
    • PUD

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
    • Inflammatory conditions: methylprednisolone 1-2mg/kg
      • Pericarditis
      • Lupus enteritis


Disposition

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


See Also

Sources

  • Rosen's
  • Up to date