When the GP saw the low haemoglobin, Jenny was immediately referred to hospital.

The admitting doctor in the medical unit contacted the on-call haematologist and rheumatologist. The clinicians all reviewed Jenny, and agreed that she did have SLE.

A direct Coombs test is positive confirming a ‘warm autoimmune haemolytic anaemia’ (see this amusing youtube video for an explanation of Coombs test: https://www.youtube.com/watch?v=4MJA8Wzp2XM)

Treatment is commenced with prednisolone 60mg daily. After two weeks (without any blood transfusion) the haemoglobin has improved to normal.

The rheumatologist recommends initiation of hydroxychloroquine 200mg daily for the lupus. Over the next 2 months the prednisolone tapers down to 5mg daily, which continues as maintenance therapy.