SLE

which is not a clinical feature of SLE ???

1)glomerulonephritis
2)deforming arthritis
3)mononeuritis multiplex
4)thrombocytopenic purpura

its 2.ref from mudit khanna of med only

• Skin: erythematous rash over the malar eminences generally with sparing of the nasolabial folds (butterfly rash); alopecia; raised erythematous patches with subsequent edematous plaques and adherent scales (discoid lupus); leg, nasal, or oropharyngeal ulcerations; livedo reticularis; pallor (from anemia); petechiae (from thrombocytopenia)
• Joints: tenderness, swelling, or effusion, generally involving peripheral joints
• Cardiac: pericardial rub (in patients with pericarditis), heart murmurs (if endocarditis or valvular thickening or dysfunction)
• Other: fever, conjunctivitis, dry eyes, dry mouth (sicca syndrome), oral ulcers, abdominal tenderness, decreased breath sounds (pleural effusions)


Diagnosis :
The diagnosis of SLE can be made by demonstrating the presence of any four or more of the following criteria of the American Rheumatism Association:
1. Butterfly rash
2. Discoid rash
3. Photosensitivity (particularly leg ulcerations)
4. Oral ulcers
5. Arthritis
6. Serositis (pleuritis, pericarditis)
7. Renal disorder (persistent proteinuria >0.5 g/day or 3+ if quantitation not performed, cellular casts)
8. Neurologic disorder (seizures, psychosis [in absence of offending drugs or metabolic derangement])
9. Hematologic disorder: a. Hemolytic anemia with reticulocytosis
b. Leukopenia (<4000/mm3 total on two or more occasions)
c. Lymphopenia (<1500/mm3 on two or more occasions)
d. Thrombocytopenia (<100,000/mm3 in the absence of offending drugs)

10. Immunologic disorder: a. Positive SLE cell preparation
b. Anti-DNA (presence of antibody to native DNA in abnormal titer)
c. Anti-Sm (presence of antibody to Smith nuclear antigen)
d. False-positive STS known to be positive for at least 6 mo and confirmed by negative TPI or FTA tests

11. ANA: an abnormal titer of ANA by immunofluorescence or equivalent assay at any time in the absence of drugs known to be associated with “drug-induced lupus” syndrome

Regarding arthritis in SLE :

Many people with lupus have joint pains – especially in the small joints of the hands and feet – which may flit from one set of joints to another quite quickly. Unlike rheumatoid arthritis, lupus does not usually cause joints to become permanently damaged or deformed, although joint pain and swelling can be the main symptoms of the disease. Perhaps 1 in 20 people with lupus develop more severe joint problems. Fewer than 1 in 20 have hypermobile and deformed joints. This is called Jaccoud's arthropathy.

Regarding Mononeuritis Multiplex causes :

diabetes mellitus
vasculitides
polyarteritis nodosa
Wegener granulomatosis
Churg-Strauss syndrome
immune-mediated diseases
rheumatoid arthritis
SLE
sarcoidosis
infections
leprosy
Lyme disease
HIV
amyloidosis
cryoglobulinemia

Regarding Glomerulonephritis in SLE :

The World Health Organization has divided lupus nephritis into five classes based on the biopsy.

Class I is histologically normal and does not show any evidence of disease.
Class II is based on a finding of mesangial lupus nephritis. This form typically responds completely to treatment with corticosteroids.
Class III is focal proliferative nephritis and often successfully responds to treatment with high doses of corticosteroids.
Class IV is diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs.
Class V is membranous nephritis and is characterized by extreme edema and protein loss.


Answer is 2