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Patients with
Patients with stable/
active disease
low disease activity
At first
Assessments
should be reviewed
visit
should be reviewed
at least every
every 6 - 12 months
1 - 3 months
Clinical
History



Vital signs (blood



pressure, heart rate,
weight)
Clinical examination



Drug review



Blood tests


Full blood count

Renal profile



Liver function test




CRP


a
a


ESR


a

a
Bone profile (calcium,
a

phosphate, ALP)
-
a

Vitamin D3
a

Immunology/serology
-
-

ANA

a

Anti-dsDNA
a



C3/C4 levels

a

aPL (LA, aCL, aβ2GPI)
a


a,p
a,p

ENA (anti-Ro/La, anti-RNP,


a
anti-Sm antibodies)
a
a
a



Immunoglobulin A, G, M
a



a
Direct Coombs’ test
Urine

UFEME


Urine random protein:
a
a

creatinine ratio OR
a


24-hour urine protein
Other investigation
a
a

Culture

a


a
Biopsy (e.g. skin, kidney)


a
a
a
a
a

Neurophysiology (e.g.


nerve conduction study,
a

a


EMG)
a
a

a

ECG
a

Echocardiogram
a

a

a

Imaging
a

Chest X-ray
a


a

a

Others (US, CT, MRI)
a
a

Management of Systemic Lupus Erythematosus
Patients with
active disease Patients with stable/
At first low disease activity
Assessments should be reviewed
visit should be reviewed
at least every every 6 - 12 months
1 - 3 months
Modifiable cardiovascular
risk factors
Hypertension   
Dyslipidaemia   a  a
Diabetes mellitus   
High BMI   
Smoking/vaping   
 = indicated;  = when indicated;  = when indicated during pregnancy; - =
a,p
a
not indicated; aβ2GP1 = anti-beta-2-glycoprotein 1 antibodies; aCL = anticardiolipin
antibodies; ALP = alkaline phosphatase; ANA = antinuclear antibody; anti-dsDNA = anti-
double stranded deoxyribonucleic acid; anti-RNP = antibodies to ribonucleoprotein;
anti-Sm antibodies = anti-Smith antibodies; aPL = antiphospholipid antibody; BMI =
body-mass index; C3 = complement 3, C4 = complement 4, CRP = C-reactive protein;
CT = computerised tomography; ECG = electrocardiogram; EMG = electromyogram;
ENA = extractable nuclear antigen; ESR = erythrocyte sedimentation rate; LA = lupus
anticoagulants; MRI = magnetic resonance imaging; UFEME = urine full examination
and microscopic examination; US = ultrasound
Adapted from: Gordon C, Amissah-Arthur MB, Gayed M, et al. The British Society
for Rheumatology guidelines for the management of systemic lupus
erythematosus in adults. Rheumatology. 2018;57(1);e1-e45.
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