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Table 1 Features that help to distinguish systemic lupus erythematosus disease activity from pregnancy-induced changes

From: Managing pregnancy in inflammatory rheumatological diseases

Unreliable features Reliable features
Facial/palmar erythema Palpable lupus rash
Arthralgia Synovitis
Anemia Alopecia (localized)
Low platelets Leucopenia (new, not drug-related)
Hypertension Red cells or casts (or both) in urine
Proteinuria Rising anti-dsDNA (anti-double-stranded DNA) antibodies
Low C4 with normal C3 25% decrease in C3 and C4 (may be in normal range)
Classical pathway activation Alternative pathway activation