Sle is a challenging condition that presents unique issues in diagnosis and management. Given this, this study aimed to investigate the clinical features and outcomes of infections in the cns in patients with sle and to establish a simplified. It should be considered as a potential diagnosis in all patients who present with multiorgan system disease. Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements c3 and c4 and creactive protein. Since there are a number of factors causing psychiatric manifestations other than sle, the diagnosis of lupus psychosis lp is often difficult. Systemic lupus erythematosus differentials bmj best practice. Sep 17, 20 the aim of this study was to analyze the changes in complements c3 and c4 and creactive protein crp in patients with systemic lupus erythematosus sle and rheumatoid arthritis ra, and to evaluate the role of these indices in the differential diagnosis. Especially, it has been sometimes challenging to discriminate steroid psychosis sp from lp, since lp usually occurs after the. Systemic lupus erythematosus and primary fibromyalgia can be distinguished by testing for cellbound complement activation products. In an attempt to find a reliable method to assess fever in patients with systemic lupus erythematosus sle, a multifactorial analysis was applied to the routine laboratory examinations, including white blood cell count wbc and serum globulin fraction concentrations. Page 2 of 15 learning objectives to learn the spectrum of ct and mr findings of systemic lupus erythematosus involving the brain cns lupus. Before the diagnosis can be established, four of 11 clinical and laboratory criteria must be met. Differential diagnosis of fever in systemic lupus erythematosus. Oct 03, 2014 fever in systemic lupus erythematosus.
Dermoscopy in the differential diagnosis between malar rash of systemic lupus erythematosus and erythematotelangiectatic rosacea. Characteristics of pleural effusions in systemic lupus erythematosus. Pdf differentialdiagnosisofsystemiclupuserythematosus. Systemic lupus erythematosus sle is a systemic multisystem autoimmune disease characterized by the presence of autoantibodies and multiorgan system involvement. Many of its clinical manifestations are secondary to the trapping of antigenantibody complexes in capillaries of visceral structures or to autoantibodymediated destruction of host cells eg, thrombocytopenia. Medline abstracts for references 15 of diagnosis and. The combined autoantibody panels identified here show promise for the diagnosis of sle and for differential diagnosis of other major rheumatic immune diseases. Systemic lupus erythematosus sle is a chronic autoimmune disease of. The diagnosis and treatment of systemic lupus erythematosus. Systemic lupus erythematosus is a systemic autoimmune disease with a worldwide distribution.
Adultonset still disease arthralgia, fever, lymphadenopathy. Apr 15, 2020 other problems to be considered in the differential diagnosis of sle include the following. Here we optimized a panel of biomarkers with three autoantibodies, obtaining an auc of 0. Pdf the aim of this study was to analyze the changes in complements c3 and c4 and creactive protein crp in patients with systemic. Raynauds phenomenon is present in almost all patients with systemic sclerosis, being the initial symptom in about 70% of patients. We report the clinical and bioptic findings for a 57yearold woman with severe chloroquineinduced myopathy. Use of these newly discovered panels of autoantibodies should improve diagnosis and differential diagnosis of sle. Ct and mr findings of systemic lupus erythematosus involving. Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskel. The avise lupus test and cellbound complement activation products aid the diagnosis of systemic lupus erythematosus. Jun 19, 2015 systemic lupus erythematosus sle is a heterogeneous autoimmune disease that may involve many different organs and display a variable clinical course. Many pharmacologic agents have been associated with a lupuslike syndrome see see druginduced lupus erythematosus, but procainamide, hydralazine, and isoniazid have been studied the most extensively. Systemic lupus erythematosus sle is a multisystem autoimmune disease that predominantly affects women of childbearing age. Characteristics of pleural effusions in systemic lupus.
Patients with sle often have raynauds phenomenon as well, but these tend not to ulcerate compared with patients with systemic sclerosis. Systemic lupus erythematosus knowledge for medical students. The differential diagnosis includes pneumonia bacterial, viral, lesslikely fungal, which would be communityacquired. Symptoms vary between people and may be mild to severe.
Psychiatric manifestations are relatively common in patients with systemic lupus erythematosus sle. Differential diagnosis must exclude diseases that may present in a similar manner. Differential diagnosis of systemic lupus erythematosus. Indian j nephrol serial online 2016 cited 2020 apr 22. Which disorders should be included in the differential. Novel biomarkers containing citrullinated peptides for diagnosis of systemic lupus erythematosus sle using protein microarrays. Systemic lupus erythematosus current medical diagnosis and. Pediatric systemic lupus erythematosus differential diagnoses. Expires july 31, 2017 systemic lupus erythematosus sle is a chronic autoimmune disease that often goes undiagnosed initially. An important differential diagnosis of nephrotic syndrome in systemic lupus erythematosus. Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli cated and challenging disease to diagnose and treat. Since 1989, she had been suffering from systemic lupus erythematosus sle with renal involvement and undergone periods of treatment with azathioprine and cyclophosphamide. Although accreditation for this cecme activity has expired, and the posttest is no longer available, you can still read the full article.
Systemic lupus erythematosus sle differential diagnoses. To know how to make the differential diagnosis of lesions of cns lupus based on lesion. Systemic lupus erythematosus is a multisystem inflammatory disease that is often difficult to diagnose. Although both men and women of all age groups can be affected, women outnumber men almost 10 fold and. The aim of this study was to analyze the changes in complements c3 and c4 and creactive protein crp in patients with systemic lupus erythematosus sle and rheumatoid arthritis ra, and to evaluate the role of these indices in the differential diagnosis of sle and ra. Before making a diagnosis of systemic lupus erythematosus sle, ruling out drugs as the cause of the condition is important. Lupus test diagnose lupus lupus diagnosis test exagen inc. Systemic lupus erythematosus diagnosis and treatment. Pdf differential diagnosis of systemic lupus erythematosus and. Systemic lupus erythematosus an overview sciencedirect topics. Clinical features of central nervous system infections and. Use of serum or bufferchanged edtaplasma in a rapid. Differential characteristics of lupus psychosis and steroid. See diagnosis and differential diagnosis of rheumatoid arthritis.
Clinical manifestations and diagnosis of systemic lupus. An inception cohort of patients with systemic lupus erythematosus from 14 european centres was followed for up to 5 years in order to describe the current early disease course. Differential diagnosis of systemic lupus erythematosus and. Systemic lupus erythematosus diagnosis and management. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Systemic lupus erythematosus sle, is the most common type of lupus. Apr 29, 2019 systemic lupus erythematosus sle is a rheumatic disease characterized by autoantibodies directed against selfantigens, immune complex formation, and immune dysregulation, resulting in damage to essentially any organ. Differential diagnosis and association of acquired. Discovery of new serum biomarker panels for systemic lupus.
The relative weight of these elements, how ever, is subject to variation according to the type of le chronic cutaneous, subacute cutaneous, and systemic, the age. Differential diagnosis and systemic lupus erythematosis. Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskeletal, renal, neuropsychiatric. Many patients who take these medications have positive antinuclear antibody test results and other serologic findings. Antinuclear antibody titer is the primary laboratory test used to diagnose systemic lupus erythematosus. Systemic lupus erythematosus sle and rheumatoid arthritis ra are systemic autoimmune diseases that may attack the bodys cells and. Nov 19, 2001 systemic lupus erythematosus sle is not uncommon. Pathogenesis 20 and clinical features 1 introduction systemic lupus erythematosus sle is the prototypic multisystem autoimmune disorder with a broad spectrum of clinical presentations encompassing almost all organs and tissues. During 74 febrile episodes, 49 sle patients showed increased disease activity and the remaining 25 febrile episodes were due. More than 90% of cases of sle occur in women, frequently starting at childbearing age. Diagnosis of systemic lupus erythematossus american. Chaudhury a r, rajarajan t, yousuf r, fernando e, kurien a a.
Occurs mainly in young women rash over areas exposed to sunlight joint symptoms in 90% of patients multiple system involvement. The list of possible differential diagnoses is broad, and will vary with the presentation of each case. Dermoscopy in the differential diagnosis between malar rash. This case adds to the growing body of evidence that lupus podocytopathy must be considered in the differential diagnosis of systemic lupus erythematosus patients presenting with nephrotic syndrome. The knowledge of the clinical manifestations of these diseases can alert the physician to the correct differential diagnosis and consequently the appropriate management in possible associations of both diseases.
Patients with sle present in many different ways and therefore may first encounter the medical system in a number of different clinics, including dermatology, nephrology, neurology, haematology or rheumatology, in both adult and paediatric care settings. The diagnosis of sle is based on characteristic clinical findings of the skin, joints, kidneys, and the central nervous system, as well as on serological parameters such as antinuclear. Dec 01, 2003 systemic lupus erythematosus is a multisystem inflammatory disease that is often difficult to diagnose. It is, by definition, a multisystem disease, and patients can present in vastly different ways. Mar 18, 2020 systemic lupus erythematosus sle is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. The exact cause is still unknown, but hormonal and immunological influences as well as genetic predisposition are considered likely etiological factors. Discoid skin lesions erythematous macules interstitial lung disease leukemia leukopenia parvovirus or. At inclusion patients n 200, 89% female, mean age 35 years, 97% caucasian, mean sledai 12. Before making a diagnosis of systemic lupus erythematosus sle, ruling out drugs as the cause of the condition is. Aug 19, 2019 in clinical practice, discrimination between central nervous system cns infections in patients with systemic lupus erythematosus sle and neuropsychiatric lupus erythematosus npsle could be urgent and critical yet extremely challenging. Systemic lupus erythematosus sle is a clinically heterogeneous disease which is autoimmune in origin, and characterized by the presence of autoantibodies directed against nuclear antigens. Differential diagnosis distinguishing features diagnostic approach. Clinical differential diagnosis of cutaneous lupus erythematosus. Sle is an inflammatory autoimmune disorder characterized by autoantibodies to nuclear antigens.
1143 560 165 443 326 1281 649 213 899 1201 755 975 1467 1554 1125 294 994 849 258 1110 893 1229 192 1518 110 1483 1285 1619 824 1393 153 1291 249 984 122 613 543 327 206