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How can systemic lupus erythematosus be treated?

Q: My 50 years old mother has been diagnosed with systemic lupus erythematosus (SLE). The doctor has asked her to take Omnacortil, HCQs, Amcard, Pantaocid and Supracal. Is she on the right mode of treatment? What precautions should we take? Following is the brief of her blood report:-

  • ANA Positive Reflex to ENA profile
  • Anti-nuclear AB-IFA, HEP2, Serum
  • Antinuclear Antibodies Positive
  • Primary Dilution 1:40
  • Primary Intensity on if 4+
  • ANA Pattern Speckled
  • Endpoint Titre 1:2560
  • DSDNA(with Titres) DNA Negative
  • Antibodies to Extractable Nuclear Antigens-1B
  • U1 ABS IMMUNOBOLT Positive
Please comment on the report cited above.

A:Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder in which the body forms antibodies to its own tissues resulting in inflammation of the small blood vessels involving virtually any part of the body. Thus, many organ systems are involved and the symptoms of the disease wax and wane over time. The cause for it is still not known. Patients may have non-specific symptoms like fever, tiredness, weight loss and joint pains or specific symptoms related to muscles and joints, skin, kidneys, lungs, heart, the gastro-intestinal tract or even the brain along with low blood counts. The American College of Rheumatology has laid down strict criteria based on both the clinical findings of the patient and the laboratory reports. A patient must have at least four of the eleven criteria listed by them to diagnose and sub-classify the disease. Nearly all patients have antinuclear antibodies (ANAs) present in blood and the presence of antibodies to native double-stranded DNA (dsDNA) is relatively specific for the diagnosis of the disease. Patients who have high ANA levels often need additional tests to subtype the ANA such as Sm, SSA, SSB, and ribonucleoprotein (RNP). The ANA test is very sensitive but not specific while anti-dsDNA is highly specific for the disorder and anti-Sm, the most specific one. Your mother needs to consult a rheumatologist who can examine her and interpret the laboratory results in the light of her clinical findings. The treatment will depend on the diagnosis and the patient’s clinical condition.


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