SLE

SLE

SLE	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 assist to differentiate SLE from other systemic rheumatic diseases. Disease activity may be monitored by FBC , ESR ; complement components C3 and C4 , complement CH50 or CH100 and, in some patients, 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	Lupus band test - skin, may be useful to differentiate between discoid and systemic lupus.
Rash esp
Vasculitis
Alopecia
Oral ulcers
Raynaud’s phenomenon	See under Cold related disorders .
Renal	Renal biopsy , if indicated.
Glomerulonephritis
Nephrotic syndrome
Haematological
Autoimmune haemolysis	Direct antiglobulin test .
Neutropenia
Lymphocytopenia
Thrombocytopenia
Lupus inhibitor	APTT , lupus inhibitor ; cardiolipin antibodies - see also Thrombosis - arterial and venous; Abortion - habitual.
Coagulation factor inhibitor	APTT , PT ; coagulation factor inhibitors.
Cardiopulmonary
Pericarditis
Myocarditis
Endocarditis
Pleurisy
Interstitial lung disease
Neurological
Organic brain syndrome	No pathology test reliably detects risk.
Psychiatric disturbance Convulsions
Stroke (cerebral thrombosis)	APTT , lupus inhibitor ; cardiolipin antibodies .
Neuropathy
Drug-induced	Antinuclear antibodies (usually homogenous staining with specificity for histones). Acetylator status may be useful; consult pathologist.
Drugs incl
Hydralazine
Procainamide
Isoniazid