All are manifestations of SLE except
D i.e. Sex ratio is nearly equal - Most authors agree that females outnumber malesQ by a ratio of --8:1 and 90% of SLE patients at diagnosis are women of child bearing age (-38 years). The condition is universal; people of all genders, ages and ethnic groups are susceptible; but SLE is 3 times more common in black people than in white. So highest prevalence is in black women and lowest in white men. - According to American rheumatism association diagnostic criteria of SLE, it may present with photosensitive, butterfly (malar) rash or discoid rash (resembling chronic DLE) Q and non erosive ahritis, oral/nasopharyngeal ulcerations, serositis, renal/neurological/hematological/ immunological disorder and ANA. - Systemic constitutional symptoms like fatigue, malaise, fever, anorexia and weight lossQ are present in 95% of patients (although these are not included in diagnostic criteria). ANA are positive in > 98% of patients so repeated negative tests suggests that the diagnosis is not SLE, unless other antibodies are present. High titer Ig antibodies to Sm antigen & ds DNA are both specific for SLE and, therefore our the diagnosis in presence of compatible clinical symptoms . Presence of multiple autoantibodies without clinical symptoms should not be considered diagnostic for SLE, although such persons are at increased risk. Nephritis is usually the most serious manifestation of SLE, since nephritis & infections are the leading causes of moality in 1st decade of disease. Since nephritis is mostly asymptomatic, urinalysis should be done in suspected cases. Renal biopsy to classify nephritis (minimal mesangial, proliferative mesangial, focal, diffuse glomerulonephritis, membranous and advanced sclerotic) is useful in planning current and near future therapies.
Lesions resemblig Chr. DLE
Butterfly rash
Photosensitivity
Sex ratio is nearly equal