5.10 World Lupus Day, an article summarizing how to fight wolves with science

May 10 is "World Lupus Day", which is a day for people with lupus erythematos.

May 10 is "World Lupus Day", which is a day for people with lupus erythematos.

Systemic lupus erythematosus is a diffuse autoimmune disease involving multiple systems and multiple organs in the body, with immune inflammation as the prominent manifestati.

 Systemic lupus erythematosus is more common in people aged 15 to 45 years old, especially in women of childbearing age, and the incidence ratio of male to female is 1:7 to 1: The latest epidemiological survey of large samples in China shows that the prevalence of systemic lupus erythematosus is 70/100,000, and the prevalence of females is as high as 113/100,00 What are the clinical manifestations of lupus erythematosus?

The clinical manifestations of systemic lupus erythematosus are complex, diverse and atypical, and are easily misdiagnosed or missed clinical.

The clinical manifestations of systemic lupus erythematosus are complex, diverse and atypical, and are easily misdiagnosed or missed clinical.

Image source network intrusion and deletion

Image source network intrusion and deletion

 

Multiorgan or multisystem involvement may also be present:

Multi-organ or multi-system involvement may also be present: Multi-organ or multi-system involvement may also be present:

① Renal involvement: 50% to 70% of patients with systemic lupus erythematosus will have renal involvement during the course of the disease, and renal biopsy shows renal pathological chang.

②Respiratory system involvement: manifested as pleurisy, pleural effusion, lupus pneumonia, interstitial lung disease, e.

③ Cardiovascular system involvement: manifested as pericarditis, pericardial effusion, myocarditis, arrhythmia , angina pectoris and even acute myocardial infarction , ST-T changes on electrocardiogram, severe systemic lupus erythematosus may be accompanied by cardiac insufficiency; pulmonary hypertension is a systemic erythematosus One of the severe manifestations of lupus, there is a risk of sudden dea.

vascular arrhythmia myocardial infarction

④ Digestive system involvement: mesenteric vasculitis, pseudo-intestinal obstruction, autoimmune pancreatitis, protein-losing enteropathy, abnormal liver function,e.

Digestion

⑤ Involvement of the blood system: anemia and/or leukopenia and/or thrombocytopenia are common; hemolytic anemia is its clinical feature, and anti-human globulin test can be positive: refractory thrombocytopenia is one of the severe manifestations of systemic lupus erythematos.

⑥ Nervous system involvement: mild cases only have migraine, personality changes, memory loss or mild cognitive impairment, and severe cases may manifest as cerebrovascular accident, coma, status epilepticus,e.

⑦Others: also include conjunctivitis, uveitis, fundus changes, optic neuropathy and other ocular involvement manifestatio.

How to treat?

Because systemic lupus erythematosus is a highly heterogeneous disease, treatment options vary from person to person, emphasizing early diagnosis and early treatment to avoid or delay irreversible pathological damage to tissues and orga.

Because systemic lupus erythematosus is a highly heterogeneous disease, treatment options vary from person to person, emphasizing early diagnosis and early treatment to avoid or delay irreversible pathological damage to tissues and orga.

①Glucocorticoids (hereinafter referred to as hormones) ①Glucocorticoids (hereinafter referred to as hormones)

Hormones play a crucial role in the treatment of SLE, and are the most commonly used basic drugs for SLE induction and remission therapy and are consistently recommended by domestic and foreign guidelines to control the disease of SL.

Hormones play a crucial role in the treatment of SLE, and are the most commonly used basic drugs for SLE induction and remission therapy and are consistently recommended by domestic and foreign guidelines to control the disease of SL.

 

• The 2020 guidelines recommend that for mildly active SLE patients, only when hydroxychloroquine or non-steroidal anti-inflammatory drugs cannot control the disease, consider using low-dose corticosteroids (prednisone ≤ 10 mg/d or equivalent doses of other corticosteroid.
  
  Control disea.
  
  

• Moderately active SLE patients were treated with moderate doses of prednisone [5 mg/(kg d)] or equivalent doses of other hormon.
  
  For patients with moderate SLE who are difficult to quickly control the disease with moderate doses of hormones, the dose of hormones can be appropriately increased, and immunosuppressive agents can be combined to reduce the cumulative dose of hormones to reduce the risk of adverse reactions caused by long-term use of hormon.
  
  

• For severely active SLE patients, standard dose of prednisone [1 mg/(kg·d)] or equivalent dose of other hormones combined with immunosuppressive therapy is recommend.
  
  

• For severe SLE patients, hormone pulse therapy is used if necessary, and for SLE patients with lupus crisis, hormone pulse therapy is directly recommend.
  
  

The 2020 guidelines recommend that for mildly active SLE patients, only when hydroxychloroquine or non-steroidal anti-inflammatory drugs cannot control the disease, consider using low-dose corticosteroids (prednisone ≤ 10 mg/d or equivalent doses of other corticosteroid.

Control disea.

The 2020 guidelines recommend that for mildly active SLE patients, only when hydroxychloroquine or non-steroidal anti-inflammatory drugs cannot control the disease, consider using low-dose corticosteroids (prednisone ≤ 10 mg/d or equivalent doses of other corticosteroid.

Control disea.

The 2020 guidelines recommend that for mildly active SLE patients, only when hydroxychloroquine or non-steroidal anti-inflammatory drugs cannot control the disease, consider using low-dose corticosteroids (prednisone ≤ 10 mg/d or equivalent doses of other corticosteroid.

Control disea.

Moderately active SLE patients were treated with moderate doses of prednisone [5 mg/(kg d)] or equivalent doses of other hormon.

For patients with moderate SLE who are difficult to quickly control the disease with moderate doses of hormones, the dose of hormones can be appropriately increased, and immunosuppressive agents can be combined to reduce the cumulative dose of hormones to reduce the risk of adverse reactions caused by long-term use of hormon.

Moderately active SLE patients were treated with moderate doses of prednisone [5 mg/(kg d)] or equivalent doses of other hormon.

For patients with moderate SLE who are difficult to quickly control the disease with moderate doses of hormones, the dose of hormones can be appropriately increased, and immunosuppressive agents can be combined to reduce the cumulative dose of hormones to reduce the risk of adverse reactions caused by long-term use of hormon.

Moderately active SLE patients were treated with moderate doses of prednisone [5 mg/(kg d)] or equivalent doses of other hormon.

For patients with moderate SLE who are difficult to quickly control the disease with moderate doses of hormones, the dose of hormones can be appropriately increased, and immunosuppressive agents can be combined to reduce the cumulative dose of hormones to reduce the risk of adverse reactions caused by long-term use of hormon.

For severely active SLE patients, standard dose of prednisone [1 mg/(kg·d)] or equivalent dose of other hormones combined with immunosuppressive therapy is recommend.

For severely active SLE patients, standard dose of prednisone [1 mg/(kg·d)] or equivalent dose of other hormones combined with immunosuppressive therapy is recommend.

For severely active SLE patients, standard dose of prednisone [1 mg/(kg·d)] or equivalent dose of other hormones combined with immunosuppressive therapy is recommend.

For severe SLE patients, hormone pulse therapy is used if necessary, and for SLE patients with lupus crisis, hormone pulse therapy is directly recommend.

For severe SLE patients, hormone pulse therapy is used if necessary, and for SLE patients with lupus crisis, hormone pulse therapy is directly recommend.

For severe SLE patients, hormone pulse therapy is used if necessary, and for SLE patients with lupus crisis, hormone pulse therapy is directly recommend.

What is hormone shock therapy?

What is hormone shock therapy? What is hormone shock therapy?

Hormone pulse therapy utilizes its non-genomic effect to quickly control the disease, which is beneficial to reduce the initial oral dose of hormones and rapidly reduce the dose, and the incidence of adverse reactions does not increase significant.

Hormone pulse therapy is intravenous infusion of methylprednisolone 500 ~ 1 000mg/d, usually continuous use for 3 days as a course of treatment, with an interval of 5 ~ 3
After the pulse therapy, other hormones of 5-1 mg/(kg·d) or equivalent doses of prednisone should be chang.

The usual treatment time is 4-8 weeks, but the specific course of treatment should be determined according to the conditi.

Both emphasize combined immunosuppressive therapy with the aim of inducing disease remission and reducing hormone dosage or even eventually discontinuing it, thereby reducing the risk of hormone-related adverse reactions during long-term remissi.

Hormone pulse therapy utilizes its non-genomic effect to quickly control the disease, which is beneficial to reduce the initial oral dose of hormones and rapidly reduce the dose, and the incidence of adverse reactions does not increase significant.

Hormone pulse therapy is intravenous infusion of methylprednisolone 500 ~ 1 000mg/d, usually continuous use for 3 days as a course of treatment, with an interval of 5 ~ 3
After the pulse therapy, other hormones of 5-1 mg/(kg·d) or equivalent doses of prednisone should be chang.

The usual treatment time is 4-8 weeks, but the specific course of treatment should be determined according to the conditi.

Both emphasize combined immunosuppressive therapy with the aim of inducing disease remission and reducing hormone dosage or even eventually discontinuing it, thereby reducing the risk of hormone-related adverse reactions during long-term remissi.

②Hydroxychloroquine

② Hydroxychloroquine ② Hydroxychloroquine

Hydroxychloroquine can combine with melanin to block the absorption of ultraviolet rays, and has anti-inflammatory, immunosuppressive and lowering blood lipid leve.

Long-term use of hydroxychloroquine in SLE patients can reduce disease activity, reduce the risk of organ damage and thrombosis , and improve the survival rate of SLE patien.

Therefore, the 2020 guidelines recommend hydroxychloroquine as a long-term basic treatment for SLE patients except for contraindicatio.

Hydroxychloroquine can combine with melanin to block the absorption of ultraviolet rays, and has anti-inflammatory, immunosuppressive and lowering blood lipid leve.

Long-term use of hydroxychloroquine in SLE patients can reduce disease activity, reduce the risk of organ damage and thrombosis , and improve the survival rate of SLE patien.

Therefore, the 2020 guidelines recommend hydroxychloroquine as a long-term basic treatment for SLE patients except for contraindicatio.

thrombus

③ Immunosuppressive drugs

③ Immunosuppressants ③ Immunosuppressants

The use of immunosuppressive agents can reduce the cumulative dose of hormones, control disease activity, improve clinical remission rates, and prevent disease recurren.

The 2020 guidelines recommend the use of immunosuppressive agents for SLE patients who are ineffective in the treatment of hormones combined with hydroxychloroquine, or those who cannot adjust the dose of hormones to less than a relatively safe do.

Use immunosuppressan.

The choice of immunosuppressants is not only affected by their advantages and disadvantages, but also should be based on the type of organ involvement , clinical manifestations, fertility requirements, drug safety and co.

Risks from long-term u.

The use of immunosuppressive agents can reduce the cumulative dose of hormones, control disease activity, improve clinical remission rates, and prevent disease recurren.

The 2020 guidelines recommend the use of immunosuppressive agents for SLE patients who are ineffective in the treatment of hormones combined with hydroxychloroquine, or those who cannot adjust the dose of hormones to less than a relatively safe do.

Use immunosuppressan.

The choice of immunosuppressants is not only affected by their advantages and disadvantages, but also should be based on the type of organ involvement , clinical manifestations, fertility requirements, drug safety and co.

Risks from long-term u.

infection prevention

Table 1 Indications, advantages and common and important adverse reactions of different immunosuppressants

Table 1 Indications, advantages and common and important adverse reactions of different immunosuppressants

④Biological agents

④Biologics ④Biologics

In SLE patients, targeted therapy against B cells has been shown to be effecti.

The 2020 guidelines recommend consideration of SLE in patients with SLE who have not responded well, are intolerant, or have relapsed after steroid and/or immunosuppressive thera.

In SLE patients, targeted therapy against B cells has been shown to be effecti.

The 2020 guidelines recommend consideration of SLE in patients with SLE who have not responded well, are intolerant, or have relapsed after steroid and/or immunosuppressive thera.

Table 2 The advantages and important adverse reactions of biologics in the treatment of systemic lupus erythematosus

Table 2 The advantages and important adverse reactions of biologics in the treatment of systemic lupus erythematosus

 

⑤Other treatment measures

⑤Other treatment measures ⑤Other treatment measures

The 2020 guidelines clarify the scope of application of plasma exchange and immunoadsorption in the treatment of S.

Because plasma exchange and immunoadsorption can only improve the clinical symptoms of patients with severe or refractory SLE in the short term, but cannot change the final outcome, they are only used as adjuvant thera.

The 2020 guidelines clarify the scope of application of plasma exchange and immunoadsorption in the treatment of S.

Because plasma exchange and immunoadsorption can only improve the clinical symptoms of patients with severe or refractory SLE in the short term, but cannot change the final outcome, they are only used as adjuvant thera.

Intravenous immune globulin may improve clinical outcomes in patients with refractory or co-infected SLE, but it should be noted that the quality of evidence is very l.

The 2020 guidelines pointed out that inappropriate use of hormones and immunosuppressants, high SLEDAI, a large number of involved organs, and a young age of onset are the main risk factors for coinfection in SLE patien.

During the treatment of SLE, attention should be paid to the assessment of SLE condition and infection risk, and the occurrence of serious complications such as infection should be reduced through rational drug use, combined with early identification and prevention of infecti.

Intravenous Immune Globulin Intravenous immune globulin may improve clinical outcomes in patients with refractory or co-infected SLE, but it should be noted that the quality of evidence is very l.

The 2020 guidelines pointed out that inappropriate use of hormones and immunosuppressants, high SLEDAI, a large number of involved organs, and a young age of onset are the main risk factors for coinfection in SLE patien.

During the treatment of SLE, attention should be paid to the assessment of SLE condition and infection risk, and the occurrence of serious complications such as infection should be reduced through rational drug use, combined with early identification and prevention of infecti.

Tripterygium wilfordii preparations have anti-inflammatory, immune-suppressing and other functions, and have a certain effect in the treatment of SLE, but should be alert to its high gonadal toxicity [incidence rate 19% (95%CI: 11% ~25%)], so it is suitable for postmenopausal women SLE patients without fertility requirements, such as women or elderly m.

Tripterygium wilfordii preparations have anti-inflammatory, immune-suppressing and other functions, and have a certain effect in the treatment of SLE, but should be alert to its high gonadal toxicity [incidence rate 19% (95%CI: 11% ~25%)], so it is suitable for SLE patients without reproductive requirements, such as postmenopausal women or elderly m.

These methods help lupus erythematosus patients

These methods help lupus erythematosus patients

• Maintain optimism : Optimism helps maintain and improve the body's immune functi.
  
  

• Persistent physical exercise can enhance physical fitness, improve the body's ability to resist diseases, and at the same time strengthen the adaptability to the external environment, but lupus patients are not suitable for strenuous exercise, and anaerobic exercise is recommended, such as walking, Tai Chi,e.
  
  

• Avoid triggering factors : For lupus patients, especially in summer, pay attention to sun protecti.
  
  Direct sunlight can easily aggravate the patient's skin damage and even cause fluctuations in the systemic conditi.
  
  

   

• Prevention of infection : Prevention of streptococcal infection is an important link in reducing the incidence of autoimmune rheumatic diseas.
  
  Patients often present with symptoms of respiratory tract infection such as sore throat and cough, and should seek medical attention in time and must not be ignor.
  
  

• Diet : Eat more fresh fruits, and supplement sufficient protein and dietary fiber every day to help the recovery of lupus erythematosus patien.
  
  

Maintain optimism : Optimism helps maintain and improve the body's immune functi.

Maintain optimism : Optimism helps maintain and improve the body's immune functi.

Stay optimistic Stay optimistic : Optimism helps maintain and improve the body's immune functi.

Persistent physical exercise can enhance physical fitness, improve the body's ability to resist diseases, and at the same time strengthen the adaptability to the external environment, but lupus patients are not suitable for strenuous exercise, and anaerobic exercise is recommended, such as walking, Tai Chi,e.

Persistent physical exercise can enhance physical fitness, improve the body's ability to resist diseases, and at the same time strengthen the adaptability to the external environment, but lupus patients are not suitable for strenuous exercise, and anaerobic exercise is recommended, such as walking, Tai Chi,e.

Persistent physical exercise can enhance physical fitness, improve the body's ability to resist diseases, and at the same time strengthen the adaptability to the external environment, but lupus patients are not suitable for strenuous exercise, and anaerobic exercise is recommended, such as walking, Tai Chi,e.

keep exercising

Avoid triggering factors : For lupus patients, especially in summer, pay attention to sun protecti.

Direct sunlight can easily aggravate the patient's skin damage and even cause fluctuations in the systemic conditi.

 

Avoid triggering factors : For lupus patients, especially in summer, pay attention to sun protecti.

Direct sunlight can easily aggravate the patient's skin damage and even cause fluctuations in the systemic conditi.

Avoid triggering factors Avoid triggering factors : For lupus patients, pay special attention to sun protection in summ.

Direct sunlight can easily aggravate the patient's skin damage and even cause fluctuations in the systemic conditi.

 

Prevention of infection : Prevention of streptococcal infection is an important link in reducing the incidence of autoimmune rheumatic diseas.

Patients often present with symptoms of respiratory tract infection such as sore throat and cough, and should seek medical attention in time and must not be ignor.

Prevention of infection : Prevention of streptococcal infection is an important link in reducing the incidence of autoimmune rheumatic diseas.

Patients often present with symptoms of respiratory tract infection such as sore throat and cough, and should seek medical attention in time and must not be ignor.

Prevention of infection Prevention of infection : Prevention of streptococcal infection is an important link in reducing the incidence of autoimmune rheumatic diseas.

Patients often present with symptoms of respiratory tract infections such as sore throat and cough, and should seek medical attention in time and must not be ignor.

Diet : Eat more fresh fruits, and supplement sufficient protein and dietary fiber every day to help the recovery of lupus erythematosus patien.

Diet : Eat more fresh fruits, and supplement sufficient protein and dietary fiber every day to help the recovery of lupus erythematosus patien.

Diet : Eat more fresh fruits, and supplement sufficient protein and dietary fiber every day to help patients with lupus erythematosus recov.

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