Pertinent Positives of an Autoimmune history

Check for family history of common autoimmune conditions

• Diabetes (type II is more heritable than type I)
• Hypo-, hyperthyroidism

Allergies

• Sulfa allergies are more common in SLE (systemic lupus erythematous) patients
  • Common sulfa drugs
    • Furosemide (ethacrynic acid is a non-sulfa loop diuretic alternative)
    • Trimetoprim-sulfamethoxazole (antibiotic also known as Septra)
    • Celecoxib (selective cyclo-oxygenase-2 inhibitor also known as Celebrex)
      • COX-2 selectivity decreases the incidence of peptic ulcer disease but is associated with increased risk of heart attacks and strokes

Symptoms

• Alopecia can be seen in SLE
• Dry eyes, mouth, vagina (dyspareunia)
  • Pathognomonic for Sjogren syndrome
  • Also seen in RA, SLE, scleroderma and hepatitis C with associated joint pain
• Oral and genital ulcers
  • Behcet disease (vasciulitis that affects all sizes)
  • Oral ulcers can seen in Crohn’s disease, SLE and reactive arthritis
• Raynaud phenomenon
  • Pathognomonic for scleroderma
  • Also seen in SLE and mixed connective tissue disease
• Photosensitive rashes as seen in SLE and Sjogren syndrome
• Palpable purpura as seen in vasculitis
• Mononeuritis multiplex as seen in vasculitis (results foot or wrist drop)
  • Pathognomonic for some form of vasculitis