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  • In Capsule Series: Rheumatology Revision

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    Mim Rashed
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    This patient, a 23-year-old female, presented with a red rash on her face, fever, joint pain, and swelling in her lower limbs. Her blood pressure was elevated and tests found anemia, a positive Coombs test, and low white blood cell count. She was admitted to the intensive care unit in a coma with seizures. The coma was likely caused by lupus cerebritis or complications from high blood pressure. Additional tests needed included those to confirm a diagnosis of systemic lupus erythematosus, urine analysis, renal function tests, a renal biopsy, and a CT brain scan. Her treatment would include therapies outlined for lupus nephritis on page 24

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    This patient, a 23-year-old female, presented with a red rash on her face, fever, joint pain, and swelling in her lower limbs. Her blood pressure was elevated and tests found anemia, a positive Coombs test, and low white blood cell count. She was admitted to the intensive care unit in a coma with seizures. The coma was likely caused by lupus cerebritis or complications from high blood pressure. Additional tests needed included those to confirm a diagnosis of systemic lupus erythematosus, urine analysis, renal function tests, a renal biopsy, and a CT brain scan. Her treatment would include therapies outlined for lupus nephritis on page 24

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    25 views1 page

    In Capsule Series: Rheumatology Revision

    Uploaded by

    Mim Rashed
    This patient, a 23-year-old female, presented with a red rash on her face, fever, joint pain, and swelling in her lower limbs. Her blood pressure was elevated and tests found anemia, a positive Coombs test, and low white blood cell count. She was admitted to the intensive care unit in a coma with seizures. The coma was likely caused by lupus cerebritis or complications from high blood pressure. Additional tests needed included those to confirm a diagnosis of systemic lupus erythematosus, urine analysis, renal function tests, a renal biopsy, and a CT brain scan. Her treatment would include therapies outlined for lupus nephritis on page 24

    Copyright:

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    of 1

    In Capsule Series Rheumatology Revision 2010 www.incapsuleseries.

    com

    ♀23 ys , red rash on her face, fever, artharlgia, edema LL , 2. Drug induced : as she is on steroid therapy.
    B.pr 200/110, Q2: explain causes of coma?
    CBC: anemia e' +ve coomb test & leucopenia. Cardiac May be due to diffuse cerebritis, vasculopathy, thrombosis
    examination: pericardial rub. She is on steroid therapy
    or infection
    Admission to ICU e' coma and convulsions
     Explain changes in CBC. Q3: other diagnostic tests needed?
     Explain causes of coma.
     Mention other diagnostic tests needed.  Investigations to confirm diagnosing SLE ( see scheme )
     Mention outline therapy.  For complications:
     Urine analysis ( proteinuria and may be hematuria)
    How to answer  Renal function tests and biopsy
     CT brain.
     Rash, arhralgia, edema LL  RHEUMATOLOGY
     B.pr 200/110, ICU, coma, convulsions  complicated Q4: Mention outline therapy?
    case
     Female, 23ys, face rash, arthralgia, steroid therapy. See rheumatology book page 24
    with IQ Chimpanzees it is SLE But, don’t forget it's a
    complicated case so with this HTN the diagnosis is likely
    LUPUS NEPHRITIS or LUPUS CEREBRITIS.

    Q1: Explain changes in CBC?

     Anemia: auto-immune hemolytic anemia (+ve coomb


    test) as SLE is an auto-immune disease.
     Leucopenia:
    1. Antibody mediated:
    Anti-neutrophils antibodies
    Anti-lymphocytes antibodies
    Anti Ro antibodies

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