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Systemic Lupus Erythematosus (SLE) Diagnosis and Clinical Features

Loopy-butterfly in Dx-collection
Picmonic
The mnemonic “I’M DAMN SHARP” can help you remember the American College of Rheumatology 1997 Revised Criteria for Classification for SLE. To be diagnosed with SLE, a patient must have at least 4 out of 11 of the diagnostic criteria.
12 KEY FACTS
IM DAMN SHARP acronym
IM DAMN SHARP needle

The mnemonic tool "I'M DAMN SHARP" is helpful in remembering all of the features of lupus. I stands for immunoglobulins present. M stands for malar rash. D represents discoid rash, A for antinuclear antibodies, M for mucositis, and N for neurological disorders, making DAMN. SHARP is made up by S for serositis, H for hematologic disorders, A representing arthritis, R standing for renal disorders and P for photosensitivity.

Immunoglobulins
In-moon-goblins

The presence of anti-dsDNA or anti-Smith or antiphospholipid antibodies is highly suggestive of SLE. Anti-dsDNA and anti-Smith antibodies are more specific for SLE than antinuclear (ANA) antibodies and their presence alone is virtually diagnostic.

Malar rash
Monarch-face-butterfly

This is the classic facial butterfly rash that exists in SLE. It involves the malar eminences and the bridge of the nose. This erythematous rash can be flat or raised and the nasolabial folds are spared unlike in the rash of rosacea.

Discoid rash
Disco Rash

Raised erythematous lesion on the face with scaling and scarring. The singer Seal’s facial scarring is due to discoid rash.

Antinuclear antibody
Anti-nuclear-power Ant-tie-body

Antinuclear antibody (ANA) is abnormally elevated in SLE and is a highly sensitive, although nonspecific, marker.

Mucositis
Mucous-on-fire

Painless oral ulcers can be present.

Neurologic disorders
Nerve-guy Disordered

Seizures or psychosis not due to other known causes can be present.

Serositis
S-rose-on-fire

Pleuritis or pericarditis can be present.

Hematologic disorders
He-man-blood Disordered

Hemolytic anemia or leukopenia or lymphopenia or thrombocytopenia can be present.

Arthritis
King-Arthur

Non-deforming arthritis affecting two or more peripheral joints. It affects MCP and PIP joints as in rheumatoid arthritis (RA) but unlike RA it is non-deforming and nonerosive.

Renal disorders
Kidney Disordered

Persistent proteinuria >0.5 gm/dL or >3 if quantitation not performed or cellular casts.

Photosensitivity
Photo-camera causing Sensitive-crying

Rash resulting from exposure to sunlight.

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