Rheumatology Approach

    Approach to Rheumatology

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    Antibodies

    • P-ANCA associated with Churg-Strauss syndrome and microscopic polyangiitis
    • Anti-Smith - specific for SLE (not sensitive, 30-50% of SLE cases have positive)
    • Anti-Smooth Muscle (smooth muscle) and Anti-LKM - associated with acute/chronic hepatitis.
    • ANA - high sensitivity, low specificity
      • collagent vascular disease. Associated with SLE and type 1 autoimmune hepatitis.
      • also drug induced lupus, polymyositis, mixed connective tissue disease, rheumatoid arthritis

     

    Other - Unclassified yet

    • Still's Disease (Adult-Onset Juvenile Rheumatoid Arthritis)
      • Evanescent Macular Rash
      • Arthralgias
      • Sore Throat
      • Leukocytosis
      • High Serum Ferritin!!
      • High ESR  
      • (DX of exclusion)
    • Polymyalgia Rheumatica
      • Pain/stiffness in neck, shoulders and hips.  (Associated with Temporal Arteritis)
      • Proximal muscle weakness
      • High ESR

    Autoimmune things presenting with fever

    • SLE
    • Stil's Disease (Adult onset juvenile rheumatoid arthritis)
    • Hypersensitivity antiitis
    • Polymyalgia rheumatica + temporal arteritis
    • Polyarteritis nodosa
    • Mixed connective tissue disase
    • Subacute thyroiditis
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