Skip to main content
. 2023 Jul 28;15(15):3359. doi: 10.3390/nu15153359

Table 1.

Diagnostic lines in SLE and dysbiosis (adapted from Fava, A. et al., Levy, D.M. et al., Tucker, L.B. et al. and Pistone, D. et al.) [18,23,24,25].

Systemic Lupus Erythematosus Dysbiosis
Sampling methods
Clinical
exam
  • –

    Fever, fatigue, lymphadenopathy, downward weight curve;

  • –

    Acute, subacute or chronic skin damage (photosensitive);

  • –

    Oral/nasal ulceration;

  • –

    Alopecia;

  • –

    Vasculitis;

  • –

    Livedo reticularis;

  • –

    Subungual telangiectasia;

  • –

    Raynaud’s phenomenon;

  • –

    Synovitis, serositis (Pericarditis, pleuritis), symmetrical polyarthritis at the metacarpophalangeal, proximal interphalangeal and knee joints (rarely erosive);

  • –

    Neuropsychiatric manifestations (convulsions, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy and acute confusional state);

  • –

    Renal damage objectified by proteinuria, cellular casts and alteration of renal function;

  • pre-moisten swabs

  • skin surface scrapes

  • tape strips

  • skin biopsies

  • nasal tamponade;

  • nasal wash;

  • nasopharyngeal mucus examination;

  • saliva/sputum;

  • oral tamponade;

  • hypopharyngeal/bronchoalveolar/gastric aspirate;

  • pharyngeal exudate;

  • bronhoalveolar lavage;

  • brushing/bronchial biopsy;

  • stool sample;

  • rectal tamponade;

  • urine/semen/vaginal secretions examination;

  • vaginal scraping/biopsy;
Clinical
investigations
  • –

    Blood count: pancytopenia (leukopenia/lymphopenia, thrombocytopenia, hemolytic anemia);

  • –

    Renal tests (urea, creatinine);

  • –

    Immunological investigations (ANA, anti-dsDNA, anti-Smith, anti-phospholipid, anti-ribonuclear, anti-Ro, anti-La, hypocomplementemia, and direct coombs test);

  • –

    Skin/renal biopsy;

  • –

    Ultrasonography;

  • –

    Spinal puncture with cerebrospinal fluid analysis;

  • –

    MRI;
Diagnosis ACR (1997)

  1. Skin eruptions of the malar/discoid type;

  2. Objectives of photosensitivity;

  3. Oral or nasal ulcers;

  4. Non-erosive arthritis at the level of the second/several joints;

  5. Serositis;

  6. Renal manifestations;

  7. Neurological manifestations;

  8. Hematological manifestations;

  9. Immunological abnormalities;

SLICC
  • –

    Lupus nephritis + one clinical and one immunological criterion;

EULAR/ACR
Remarks
Differential diagnosis in childhood:
  • ✓

    Cytomegalovirus, Epstein Barr, Parvovirus 19, HIV;

  • ✓

    Bacterial sepsis, Brucella, Leptospira;

  • ✓

    Q fever, tuberculosis, Lyme disease;

  • ✓

    Leukemia, lymphoma, neuroblastoma, histiocytosis;

  • ✓

    Autoimmune diseases;

  • ✓

    Medications that induce lupus;

SLICC—Systemic Lupus Collaborating Clinics, EULAR—European League of Associations for Rheumatology, ACR—American College of Rheumatology, ANA—anti-nuclear antibodies, anti-ds-DNA—antibodies against double-stranded DNA.