Rheumatology for UPSC CMS: RA, SLE, Vasculitis and the Autoantibody Panel Explained

Rheumatoid Arthritis#

Symmetrical small joint polyarthritis. Morning stiffness >1 hour. RF (70%) + Anti-CCP (specific). Extra-articular: nodules, pulmonary fibrosis, vasculitis, amyloidosis.

Treatment: Methotrexate (first-line DMARD) + Sulfasalazine + Hydroxychloroquine (triple therapy). Add steroids for flare. Biologics (TNF-alpha inhibitors) for refractory.

SLE#

Malar rash, photosensitivity, oral ulcers, arthritis, serositis, renal (nephrotic syndrome), neuro (seizures, psychosis), hematological.

ANA (sensitive, not specific), Anti-dsDNA (specific, correlates with disease activity), Anti-Sm (specific).

Vasculitis#

PAN: Polyarteritis nodosa. Medium vessel. HBV associated. No pulmonary involvement.
GPA (Wegener): c-ANCA (PR3). Upper airway, lung, kidney.
MPA: p-ANCA (MPO). Pulmonary-renal syndrome.