SYSTEMIC LUPUS ERYTHEMATOSUS

Measures:

Lab Studies:

Immunological Tests:

Chemical Pathology Test/s:

Haematology Tests:

Histological Test/s:

Routine Radiological Study:

Additional tests that may be asked to rule out/monitor clinical/subclinical lupus nephritis:

Additional test that may be asked in a SLE case with recurrent pneumonitis / shrinking lung syndrome:

Additional test that may be asked in a SLE case with Libman-Sacks Endocarditis:

Additional tests that may be asked in patients with SLE and myositis, cutaneous vasculitis and patients with overlap syndromes:

Additional tests that may be asked in a suspected case of cerebral lupus or new onset generalized seizures:

Additional tests that may be asked in drug-induced lupus erythematosus (DILE):

Additional tests that may be asked in a suspected case of antiphospholipid syndrome (APS), especially in a pregnant lady:

Additional test that may be asked in postmenopausal women and patients on long-term corticosteroids:

Tests which yield 'false positive' results in SLE patients:

Interpretation of Measures:

In a SLE patient, what to expect from the test for:

Antinuclear Antibody (ANA):

Anti-dsDNA Antibodies:

Anti-ssDNA Antibodies:

Anti-histone Antibodies:

Anti-Sm Antibodies:

Anti-SSA/Ro and SSB/La Antibodies:

Antibodies to ribosomal P protein:

Antiphospholipid Antibodies:

  1. Unexplained 2nd or 3rd trimester fetal death or stillbirth.
  2. Past history of three or more spontaneous abortions.
  3. Severe preeclampsia at less than 34 weeks of gestation
  4. Severe fetal growth restriction.

Quantitative immunoglobulins:

Activated partial thromboplastin time (aPTT):

Rheumatoid Factor (RF):

Coombs Antibody:

ESR & CRP:

Complete Blood Count (CBC):

Renal Function Tests:

Liver Function Tests:

Serum Creatinine Kinase:

Complement levels C3, C4, CH50:

Electrolytes, Glucose, Calcium & ABG's:

Plain radiographs of the joints:

Chest X-Ray:

Brain MRI/magnetic resonance angiography (MRA):

Electroencephalography (EEG):

Lumbar Puncture:

Echocardiogram :

EMG and nerve conduction studies (NCS):

Dual energy x-ray absorptiometry (DEXA):

Pulmonary Function Tests:

Renal Biopsy:

WHO Classification of SLE Nephritis:
Type Histological Appearance
1 Normal
2a Mesangial deposits
2b Mesangial hypercellularity
3 Focal segmental nephritis
4 Diffuse proliferative nephritis
5 Membranous nephritis

Since sampling errors is not a rarity during renal biopsy, the results of the biopsy should always be correlated with the clinical and laboratory findings. Different studies have suggested that the biopsy specimens should be sent to those pathologists who are working in larger medical centres with substantial SLE patient populations. Renal biopsy has predictive prognostic value - advanced is the type of lupus nephritis, worse is the prognosis and thus aggressive should be the treatment regimen.

Skin Biopsy:


 


Document Provenance and History

Document Author: Dr. Fazal Danish

Document Created: 4th July 2006

Document Edits: