SLE: in an appropriate ckinical setting if out of 11 criteria are present A RASH POINts MD.

Arthritis Renal disease (proteinuria, cellular casts) ANA (positive antinuclear antibody) Serositis (pleurisy or pericarditis) H aematological disorders (haemolytic anaemia or leucopenia or lymphopenia or thrombocytopenia) Photosensitivity Oral ulcers I mmunological disorder (positive LE cell, anti-DNA, anti-Sm, false positive serological test for syphilis) N eurological disorders (seizures or psychosis, in the absence of other causes) Malar rash Discoid rash Monitoring activities 1. Double-stranded (anti-ds) DNA antibody titres. 2. Complement : decrease in c3 and c4( denote consumption of complement) 3. ESR increase while C-reactive protein often normal Antiphospholipid syndrome : occure secondary to SLE (in 20-30%)or as primary disease. Present of anti cardiolipin antibody and lupus anticoagulants. CLOT C oagulation defect L ivedo reticularis O bstetric : recurrent miscarriage T hrombocytopenia