Multisystem autoimmune disease with autoantibodies against nuclear antigens and immune-complex deposition.
Clinical features
- • Malar rash, photosensitivity
- • Arthralgia, oral ulcers
- • Serositis (pleuritic pain)
- • Fatigue, fever
- • Renal, neurological or haematological involvement
Investigations
- • ANA (sensitive), anti-dsDNA and anti-Sm (specific)
- • Complement C3/C4 fall with activity
- • Urinalysis and protein:creatinine ratio for nephritis
- • Antiphospholipid antibodies
Management
- • Hydroxychloroquine for all patients
- • Steroids for flares with steroid-sparing agent (azathioprine, mycophenolate)
- • Lupus nephritis: mycophenolate or cyclophosphamide induction
- • Sun protection, cardiovascular risk reduction
Clinical pearls
- • ESR rises but CRP often stays normal — a high CRP suggests infection
- • Anti-Ro crosses the placenta and causes congenital heart block
Related in WardRound
Educational — verify locally.
