10/27/15 Morning Report SLE

Teaching Pearls: 

  • ANA negative lupus, check SSA/SSB which are associated with neonatal lupus and congenital heart block
  • ANA positive in 99% of patients with lupus, but low specificity
  • double stranded DNA antibodies are used to monitor disease severity in lupus
  • check C3, C4, and double stranded DNA to work up possible lupus flare
  • Drug induced lupus: Look for positive ANA and anti-histone antibodies. Also look for exposure to procainamide, hydralazine, chlorpromazine, PTU, phenytoin, minocycline, and TNF inhibitors.
Steroid Duration Equivalent Dosing
Dexamethasone Long-acting 1 mg
Methylprednisolone Intermediate-acting 4 mg
Prednisone Intermediate-acting 5 mg
Hydrocortisone Short-acting 20 mg

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