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SLE Patient Case Studies: Christa

Hypothetical Patient

As a mother of two active school-aged children, Christa, who’s been taking antimalarials plus low-dose glucocorticoids, has had to reduce her involvement in her kids’ lives due to being confined to her home due to her symptoms. SLE can greatly impact a patient’s ability to function in their normal life.

Use the SELENA-SLEDAI tool to objectively assess a patient's overall disease activity. It is included in these case studies for the purpose of demonstrating how the variables you may already be evaluating in your clinical practice correlate with the SELENA-SLEDAI disease descriptors.

History

  • Diagnosed with SLE 8 years ago
  • Had 2 flares in the first year (joint pain in fingers), resulting in higher glucocorticoid doses
  • Higher glucocorticoid dosage has led to side effects (weight gain and swelling of the ankles)
  • Feels her disease is getting worse

Clinical Profile

  • Persistent pain in the proximal interphalangeal joints
  • Pleurisy
  • Recurrent photosensitive discoid rash
  • Constantly tired and aching, and has rashes on her face and ears

Medication History

  • Antimalarial agent since diagnosis
  • Low dose glucocorticoids daily since last flare
  • Intramuscular glucocorticoid injections as needed to control joint pain and stiffness
  • Immunosuppressive agents
Lab Values
Hemoglobin (g/dL) 10.2
Platelets (x109/L) 170
WBCs (x109/L) 3.2
Urinalysis Normal
Creatinine (mg/dL) 1.0
Anti-dsDNA (IU/mL) 150
Complement C3 and C4 (mg/dL) 88 and 9
Lymphocytes (x109/L) 1100
WBCs (x10 9/L)
Anti-dsDNA (IU/mL)

SELENA-SLEDAI SCORE: 12 points
(Arthritis 4 points, Pleurisy 2 points, Rash 2 points, Elevated anti-dsDNA titer 2 points, Low complement 2 points)

 

Review Denise’s case study.

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