Tag 3 - Frage A71/B101 - ACR-Kriterien

[Zoidberh]

Ich habe mal die Internetseite des American College of Rhemathology angeschaut und nach den Kriterien des SLE gesucht. http://www.rheumatology.org/publicat...le.asp?aud=mem

Alle Antwortmöglichkeiten stehen da drin! Das macht mich etwas stuzig. Vielleicht sind die Läsionen im Mund bei dieser Patientin nicht typisch für den Lupus, das kann sein. Aber mir klingt das Fallbespiel schon nach Ulzerationen. Aber wahrscheinlich meinten die das. Wäre schon sehr spitzfindig.



Back To Classification Criteria
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus
Criterion Definition
1. Malar rash Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds

2. Discoid rash Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions

3. Photosensitivity Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation

4. Oral ulcers Oral or nasopharyngeal ulceration, usually painless, observed by physician

5. Arthritis Nonerosive arthritis involving 2 or more peripheral joints, characterized by tenderness, swelling, or effusion

6. Serositis

a) Pleuritis--convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion
OR
b) Pericarditis--documented by ECG or rub or evidence of pericardial effusion

7. Renal disorder

a) Persistent proteinuria greater than 0.5 grams per day or grater than 3+ if quantitation not performed
OR
b) Cellular casts--may be red cell, hemoglobin, granular, tubular, or mixed

8. Neurologic disorder

a) Seizures--in the absence of offending drugs or known metabolic derangements; e.g., uremia, ketoacidosis, or electrolyte imbalance
OR
b) Psychosis--in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance

9. Hematologic disorder

a) Hemolytic anemia--with reticulocytosis
OR
b) Leukopenia--less than 4,000/mm<>3<> total on 2 or more occasions
OR
c) Lyphopenia--less than 1,500/mm<>3<> on 2 or more occasions
OR
d) Thrombocytopenia--less than 100,000/mm<>3<> in the absence of offending drugs

10. Immunologic disorder

a) Positive LE cell preparation
OR
b) Anti-DNA: antibody to native DNA in abnormal titer
OR
c) Anti-Sm: presence of antibody to Sm nuclear antigen
OR
d) False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test

11. Antinuclear antibody An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with "drug-induced lupus" syndrome

[dr.pepper]

die hat meiner meinung nach nur eine 1a landkartenzunge...

[Unregistriert]

yepp, lingua geographicab kompliziert beschrieben, aber irgendwie doch unverwechselbar

[Zoidberh]

Stimmt! War ich zu blöd.

[Unregistriert]

Anti Sm Antikörper sind richtig, aber nicht die Ratio.
Ich bleibe bei Antwort D.