skip to main content

Infection vs SLE Flare — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatologyInfection vs SLE FlareRACP Adult Medicine

A 30-year-old woman with known SLE on hydroxychloroquine and mycophenolate presents with fever (39°C), rising CRP (120 mg/L), and leucocytosis (WCC 18 × 10⁹/L with neutrophilia). Anti-dsDNA is stable. Complement levels are unchanged. She has dysuria and pyuria. What is the most likely explanation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Intercurrent infection (UTI)

In SLE, ELEVATED CRP is unusual during a disease flare (CRP is typically low/normal). Significantly elevated CRP with neutrophilia in SLE should prompt investigation for intercurrent infection. Dysuria and pyuria confirm UTI. Immunosuppressed SLE patients are at increased infection risk. The stable anti-dsDNA and complement support that this is NOT a lupus flare. Treat the infection while continuing immunosuppression.

Reference: EULAR – 2024 – SLE Management; eTG Rheumatology 2024