The Cribsiders S4 Ep77: Childhood-Onset SLE - Is It Sometimes Lupus?
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Feb 1, 2023 Dr. Rebecca Sadun, an expert rheumatologist from Duke, dives into the complexities of childhood-onset systemic lupus erythematosus. She sheds light on diagnostic challenges, emphasizing thorough history-taking and tailored laboratory tests. The discussion includes insights on effective treatment strategies, particularly the use of hydroxychloroquine and steroids. Dr. Sadun also addresses the importance of personalized care and the impact of socioeconomic factors on patient outcomes, making it clear that understanding lupus in pediatrics is crucial for better management.
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ANA Ordering
- Order ANA with other lupus labs if suspicion is high.
- Avoid ordering ANA alone for low lupus suspicion due to high false positives.
Rheumatology Panels
- No universal "rheumatology panel" exists.
- Each autoimmune disease requires specific antibody tests, and overlapping results can be misleading without correlating symptoms.
Follow-up on Positive ANA
- If ANA is significantly positive, follow up with ENA panel.
- Include tests for Rho, LA, RNP, SM, and double-stranded DNA, as the ANA alone is nonspecific.
