Diferencia entre revisiones de «Systemic lupus erythematosus»
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==Background== | ==Background== | ||
*Autoimmune disorder affecting all | *Autoimmune disorder affecting all systems | ||
==Epidemiology== | ==Epidemiology== | ||
* | *Female:Male 10:1 | ||
*More common in African Americans | *More common in African Americans | ||
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***Cover for ''[[Listeria]]'' and ''[[Pseudmonas]]'' | ***Cover for ''[[Listeria]]'' and ''[[Pseudmonas]]'' | ||
**CAD | **CAD | ||
***More common and more complications post-PCI | |||
**[[PE]] | **[[PE]] | ||
**[[Pericarditis]] | **[[Pericarditis]] | ||
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**[[Stroke]] | **[[Stroke]] | ||
**[[Encephalitis]] | **[[Encephalitis]] | ||
**[[Meningitis]] | |||
*Musculoskeletal | *Musculoskeletal | ||
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==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 | |||
Revisión del 22:31 25 mar 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:
- Malar rash
- Discoid rash
- Photosensitivity
- Oral ulcers
- Arthritis (polyarticular)
- Serositis (Pericarditis or pleuritis)
- Renal disorder (renal failure, protenuria, casts)
- Neurologic or psychotic symptoms
- Hematologic (anemia, thrombocytopenia, or leukopenia)
- Immunologic (+antibofy testing)
- ANA (positive ANA)
New Presentations
Flairs
- Cardiopulmonary
- Pneumonia
- Cover for Listeria and Pseudmonas
- CAD
- More common and more complications post-PCI
- PE
- Pericarditis
- Endocarditis
- Infectious and Libman-Sachs
- Pneumonia
- Neuropsychiatric/Altered mental status
- Non-convulsive status epilepticus
- CNS vasculitis
- Stroke
- Encephalitis
- Meningitis
- Musculoskeletal
- Arthritis
- Usually symmetric
- Consider septic arthritis if there is a single inflamed joint
- Cover for ''Salmonella'' in addition to standard coverage
- Arthritis
Differential Diagnosis
- Rheumatoid arthritis
- Sjogren's syndrome
- Dermatomyositis
- Polymyositis
- Stevens-Johnson syndrome
- Toxic Epidermal Necrolysis
- Septic arthritis
- Lyme disease
- Vasculitis
- Acute Rheumatic Fever
- Toxic Shock Syndrome
- TTP
- ITP
- DIC
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
- Arthritis
- Fever and Rash
- Lupus Anticoagulant
- Pericarditis
- Pericardial Effusion and Tamponade
- Acute Renal Failure
- Adrenal Crisis
Sources
- Rosen's
- Up to date