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Lupus Injury

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Because no single measure can describe status in all SLE patients, standardized indices for assessing SLE disease activity have been created. In addition To the Physicians’Global Assessment (an estimate of activity rated on a 0 to 3 visual analog scale), the most common measures used include the SLE Disease Activity Index (SLEDAI), the British Isles Lupus Assessment Group (BILAG), the Systemic Lupus Activity Measure (SLAM), the Lupus Activity Index (LAI)68,70, and the European Consensus Lupus Activity Measurement (ECLAM). All of these indices are valid, reliable, and comparable. Some of them are easy to incorporate into routine clinical care, giving a quick snapshot of a patient’s status70. The SLEDAI is perhaps the easiest assessment tool to use. Twenty-four …show more content…

How to sense lupus flare from symptoms71
The following are the clinical features which are can be considered as a warning of impending flare: Increasing fatigue Arthralgias and myalgias New or worsening rash
Persistent headache
Fever
Abdominal pain.

Renal Flare
Nephritis is characterized by peripheral oedema secondary to hypertension or hypoalbuminemia During flare, the WHO histopathological class changes to a higher level with additional features of activity or chronicity. Basic haematological profile reveals anaemia,
ESR and thrombocytosis. Urine examination will show proteinuria, increased WBCs, haematuria and casts. Complement levels fall.

Haematological Flare
Acute immune haemolytic anaemia with a sharp fall in haemoglobin (>3gm), spherocytes on peripheral smear, raised bilirubin and reticulocyte count and a positive Coomb’s test confirm haemolytic process. Leucopenia and lymphopenia correlate with disease flare
Thrombocytopenia may be due to antiplatelet or antiphospholipid antibodies(APLA).

. Central Nervous System (CNS) flare
The ACR criteria for NPSLE have been mentioned in clinical manifestations of CNS lupus.

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