Lady presents with joint pain in both knees and low grade fever off and on. On examination she has a rash on sun exposed parts. Clinical diagnosis?

Ans. (a) SLERef.: Harrison 19th ed. / 2126-27The diagnosis is based on joint pain in fever with rash and photosensitivity. Rheumatoid arthritis involves the small joints symmetrically and does not have presence of Rash.The diagnostic criteria for SLE are as follows:* Rash Fixed erythema, over the Malar Eminences* Erythematous circular raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur* Photosensitivity Exposure to UV light causes rash* Oral ulcers Includes oral and nasopharyngeal ulcers* Synovitis/Non-erosive arthritis of two or more peripheral joints* Serositis: Pleuritis or pericarditis documented by ECG or rub or evidence of effusion* Renal disorder Proteinuria >0.5 g/d or 3+, or cellular casts* Neurologic disorder Seizures or psychosis without other causes* Hematologic disorder Hemolytic anemia or leukopenia* Immunological criteria like positive CRP, low C3, ELISA cardiolipin antibody* ANA positivity