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Rheumatology

Question
32 out of 37
 

Which of the following condition compliment level is reduced? (AIIMS Nov 08)



A SLE

B Cryoglobulinemia

C Membranoproliferative GN

D All of the above

Ans. D All of the above

Autoantibodies in SLE

Autoantibodies in Systemic Lupus Erythematosus (SLE) (Ref: H-18th edition, Pg-2726, table 319.1)

Antibody

Prevalence, %

Clinical Utility

Antinuclear antibodies

98

Best screening test; repeated negative tests make SLE unlikely

Anti-dsDNA

70

High titers are SLE-specific and in some patients correlate with disease activity, nephritis, vasculitis

Anti-Sm

25

Specific for SLE; no definite clinical correlations; most patients also have anti-RNP

Anti-RNP

40

Not specific for SLE; high titers associated with syndromes that have overlap features of several rheumatic syndromes including SLE.

Anti-Ro (SS-A)

30

Not specific for SLE; associated with sicca syndrome, subacute cutaneous lupus, and neonatal lupus with congenital heart block; associated with decreased risk for nephritis

Anti-La (SS-B)

10

Usually associated with anti-Ro; associated with decreased risk for nephritis

Antihistone

70

More frequent in drug-induced lupus than in SLE

Antiphospholipid

50

predisposes to clotting, fetal loss, thrombocytopenia

Antierythrocyte

60

Measured as direct Coombs' test; a small proportion develops overt hemolysis

Antiplatelet

30

Associated with thrombocytopenia but sensitivity and specificity are not good; this is not a useful clinical test

Antineuronal (includes anti-glutamate receptor)

60

In some series a positive test in CSF correlates with active CNS lupus

Antiribosomal P

20

In some series a positive test in serum correlates with depression or psychosis due to CNS lupus

Extra Edge:

a. Antinuclear antibodies – Most sensitive test.

b. Anti – DNA – Anti ds DNA is most specific

c. Complement level are reduce in SLE.

Extra Edge:

Immune complex diseases associated with hypocomplementemia (AIIMS Nov 08)

1. SLE

2. Vasculitis

a. Hypocomplementemic urticarial vasculitis

b. Polyarteritisnodosa (especially hepatitis B-associated) (necrotizing vasculitis)

3. Glomerulonephritis

a. Post-streptococcal b. Membranoproliferative c. Cryoglobulinemia (types II and III)

4. Bacterial endocarditis

5. Serum sickness

Rheumatology Flashcard List

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