Presentation and Risk Factors
Characterized by a vivid crimson or violaceous hue, this mildly desquamating eruption across the malar region and nasal bridge serves as a hallmark cutaneous manifestation of Systemic Lupus Erythematosus.
Malar or "Butterfly rash"
A specific lab test used in the workup of pancytopenia to determine if red blood cells are being destroyed by autoantibodies coating their surface.
Direct Coombs test
This type of hypersensitivity reaction is associated with the majority of Systemic Lupus Erythematosus cases.
Type III
To mitigate the unremitting progression of this autoimmune onslaught, clinicians often turn to this diverse pharmacological class of agents, designed not merely to palliate symptoms but to fundamentally alter the disease’s trajectory by arresting the underlying immunological mechanisms of tissue destruction.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs);
Despite his team constantly suggesting it, Dr. House famously maintains that "It's never" this autoimmune disease.
Lupus
Genetic susceptibility to this multisystemic pathology is frequently traced to the inheritance of these dual human leukocyte antigen alleles, specifically those residing within the MHC Class II region.
HLA-DR2 and HLA-DR3
This hallmark of serositis is defined by a discordant friction between the visceral and parietal layers; whether involving the pulmonary or cardiac envelopes, it announces itself through piercing pleuritic distress and the telltale auditory rasp of a rubbing signature.
Serositis
In SLE, these circulating proteolytic precursors are described as being "consumed" or depleted because they are used up during the activation of the classical pathway.
C3 and C4 (Complement)
In the urgent management of an acute immunological tempest, these potent synthetic analogues of the adrenal cortex's own secretions are deployed for their profound genomic influence, rapidly quelling the inflammatory fire by suppressing the transcription of pro-inflammatory cytokines and stabilizing the body's overactive defenses.
Glucocorticoids
Dr. House famously relies on this specific opioid pain medication to manage the chronic pain in his right leg.
Vicodin
While the origins of this multisystemic illness remain shrouded in mystery, clinical observation points toward a triad of these provocative influences.
Women of childbearing age, individuals of African, Hispanic, or Asian descent, UV light, smoking, and certain viral infections (EBV).
This antibody is near 99% specific for SLE, making its presence virtually diagnostic, though it is only present in 20-30% of patients.
Anti-Smith (Anti-Sm)
In the kidneys, anti-dsDNA complexes primarily deposit in these two specific glomerular locations to initiate the inflammatory influx.
The glomerular basement membrane (subendothelial space) and the mesangium, causing glomerulonephritis.
In the molecular landscape of the endosome, this antimalarial agent acts as a chemical sentinel, sequestering protons to elevate the pH and thereby thwarting the activation of these nucleic-acid sensing proteins, an inhibition that ultimately silences the interferon-alpha-driven clarion call of the innate immune system.
Hydroxychloroquine; Toll-like receptors (TLRs)
While he specializes in nephrology, House's best (and perhaps only) friend, James Wilson, heads this department at Princeton-Plainsboro.
Oncology
Neurological manifestations in this systemic pathology extend far beyond mere diffuse inflammation, arising instead from a dichotomous assault upon the central nervous system: one characterized by ischemic compromise via small-vessel vasculopathy, and the other by the insidious infiltration of pathogenic autoantibodies across a breached blood-brain barrier.
Vasculitis and antineuronal antibodies
Should the heart's shadow transcend its typical boundaries on a frontal film, adopting the classic 'water-bottle' configuration, it signals a transition from simple serositis to a more profound pericardial effusion or the intrinsic muscular distress of myocarditis.
An enlarged cardiac silhouette/cardiomegaly?
This specific hypersensitivity mechanism is responsible for the development of autoimmune hemolytic anemia and thrombocytopenia in SLE.
Type II hypersensitivity
While Hydroxychloroquine is generally well-tolerated, its chronic accumulation within the melanin-rich tissues of the uvea necessitates vigilant surveillance for this permanent maculopathy, characterized by a central island of preserved vision surrounded by a ring of pigmentary attenuation.
Bull's eye maculopathy (retinal toxicity)
In the Season 4 finale, "Wilson's Heart," this character—nicknamed "Amber-Alert" by House—tragically dies following a bus crash.
Amber Volakis
This physiological transition marks the shift from asymptomatic autoantibody presence (like ANA or anti-Ro/La) to the actual inflammatory cascade of clinical disease.
Transition from the "Early Phase" (or Pre-clinical phase) to "Established Disease"
This exuberant fibrinous exudate, having escaped the inflamed vasculature, bestows upon the serous surfaces a chaotic, villous texture—a phenomenon colloquially described by its resemblance to congealed dairy or a coarse, shaggy tapestry of immunological distress.
Fibrinous serositis
In the "early phase" of the disease, these two specific antibodies can often be detected in the serum years before the patient experiences their first clinical flare.
ANA and anti-Ro/La (SSA/SSB)
In the clinical calculus of prescribing this antimalarial, one must exercise the utmost caution if the patient harbors a pre-existing immunological disdain for this specific nitrogenous bicyclic heterocycle, as a prior adverse reaction to any member of this pharmacologic family renders the therapy a dangerous provocation rather than a cure.
4-aminoquinolines
Before starring as the titular doctor, this British actor gained fame in the UK as part of a comedy duo with Stephen Fry.
Hugh Laurie