SLE

Last updated: Saturday, 05, February, 2011

Presentation	Appropriate Tests
	Diagnosis is based on defined clinical and pathological criteria which include positive antinuclear antibodies and/or positive antibodies to double stranded DNA. Rheumatoid factor and extractable nuclear antigen antibodies (especially the presence of Sm Antibody) assist to differentiate SLE from other systemic rheumatic diseases. Disease activity may be monitored by FBC, ESR; and in some patients complement components C3 and C4 and levels of double stranded DNA antibodies. Creatinine, urea, AST, ALT and CRP may assist to define the extent of disease and complications; lupus inhibitor and cardiolipin antibodies may also predict complications of disease.
Systemic features Fever Malaise Weight loss
Musculoskeletal Arthritis - polyarticular Myalgia Myopathy
Skin and mucous membranes Rash, especially Vasculitis Alopecia Oral ulcers Raynaud's phenomenon	Lupus band test - skin, may be useful to differentiate between discoid and systemic lupus See under Cold related disorders
Renal Glomerulonephritis Nephrotic syndrome	Renal biopsy, if indicated.
Haematological Autoimmune haemolysis Neutropenia Lymphocytopenia Thrombocytopenia Thrombosis	Direct antiglobulin test. See Haemolysis APTT, lupus inhibitor; cardiolipin antibodies, Beta-2 glycoprotein 1 antibodies.
Coagulation factor inhibitor	APTT, PT; coagulation factor inhibitors.
Abortion - habitual	Antiphospholipid antibody syndrome.
Cardiopulmonary Pericarditis Myocarditis Endocarditis Pleurisy
Intestitial lung disease
Neurological Organic brain syndrome Psychiatric disturbance Convulsions Stroke (cerebral thrombosis) Neuropathy	No pathology test reliably detects risk. APTT, lupus inhibitor; cardiolipin antibodies, Beta-2 glycoprotein 1 antibodies.
Drug induced lupus, due to
Hydralazine Procainamide Isoniazid