Pediatric emergency medicine trisk 2927 2927

time and in the
absence of drugs
known to be
associated with
“drug-induced
lupus” syndrome

Low complement

laboratory
reference range
Presence of antibody
to Sm nuclear
antigen
Antiphospholipid
antibody positive,
by any of the
following: Lupus
anticoagulant;
false-positive
RPR; medium or
high titer
anticardiolipin
(IgA, IgG, or
IgM); or positive
test result for
anti–beta-2
glycoprotein I
(IgA, IgG, or
IgM)
Low C3; low C4; or

low CH50

Direct Coombs test Direct Coombs test
in the absence of
hemolytic anemia
Although the new criteria and definitions were intended as classification symptoms
to be used for research, they are often used by clinicians to establish a diagnosis.
Nonetheless, patients may have SLE and not fulfill criteria, or they may meet criteria
despite having another illness.
The SLICC criteria begin with four separate dermatologic manifestations and
differentiates acute from chronic lesions. Acute cutaneous lupus includes the typical
malar erythematous rash with butterfly distribution and sparing of the nasolabial folds,
as well as photosensitivity and bullous lupus. Chronic cutaneous lupus includes
classical discoid lesions, both localized and generalized ( Fig. 101.1 ). Mucosal lesions
(macular and ulcerative) may involve the nose or the mouth, particularly the palate (
Fig. 101.2 ) and are usually painless. Nonscarring alopecia in the absence of other
causes such as alopecia areata, drugs, and iron deficiency is now its own separate
criterion. The arthritis criteria include joint-line tenderness with 30 minutes of morning