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Rheumatology

Question
35 out of 37
 

Indications of steroids in SLE are all except: (PGI Dec 09)



A Myocarditis
B Endocarditis

C Thrombocytopenia
D Neuropsychiatric symptoms

E Pleural effusion

Ans. A Myocarditis, B. Endocarditis

Indication steroid therapy in SLE (Ref. H 18th Pg-2733)

1. Nephritis 2. Thrombocytopenic purpura 3. Hemolytic anemia

4. Pericarditis 5. Convulsion

Extra Edge: It has not been proven that glucocorticoid or other immunosuppressive therapies lead to improvement of lupus myocarditis or endocarditis, but it is usual practice to administer a trial of high-dose steroids along with appropriate supportive therapy for heart failure, arrhythmia or embolic events. (Ref. H 18th Pg-2733)

Manifestations of SLE which don't improve to immunosuppression are

1. Clotting disorders 2. Behavior abnormalities 3. End stage GN

Table 319-5 Medications for the Management of SLE (H-18thPg 2732)

Medication

i. NSAIDs, salicylates St. Joseph's aspirin (low dose aspirin)

ii. Topical glucocorticoids iii. Topical sunscreens

iv. Hydroxychloroquine (quinacrine can be added or substituted) v. DHEA (dehydroepiandrosterone)

vi. Methotrexate (for dermatitis, arthritis) vii. Glucocorticoids, oral

viii. Methylprednisolone sodium succinate, IV ix. Cyclophosphamide IV

x. Mycophenolatemofetil or mycophenolic acid xi. Azathioprine

xii. Belimumab xiii. Rituximab

Recent Advances: Belimumab& Rituximab are new drugs being used for SLE. (H-18thPg- 2732)

Rheumatology Flashcard List

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