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TERAPIA DEL LES E SINDROMI CORRELATE

Gabriel
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TERAPIA DEL LES E SINDROMI CORRELATE

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    2. “ IT’S NOT THE SAME OLD LUPUS ANY MORE ”

    9. The major risk factor for retinal toxicity appears to be the combination of cumulative dose >800 gm and age >70 years (presumably due to the increased prevalence of macular disease in the elderly) A baseline eye evaluation is not routinely recommended in patients younger than age 40 and with no family history of eye disease. If a patient has had a clinical response to HCQ after 6 months, then a monitoring routine should be instituted. Patients with abnormal renal function or those who have received HCQ for more than 10 years require more frequent ophthalmologic evaluation. In the absence of risk factors, it is recommended that an ophthalmologic examination and central field testing be performed every 6-12 months. The central 10[degree] of the visual field is the initial site of antimalarial retinal toxicity. An Amsler test or a modified Amsler test can be used to screen for this early abnormality (35). This can be administered by self-testing if the patient is reliable, or by the patient's primary physician, to augment formal ophthalmologic testing. The major risk factor for retinal toxicity appears to be the combination of cumulative dose >800 gm and age >70 years (presumably due to the increased prevalence of macular disease in the elderly) A baseline eye evaluation is not routinely recommended in patients younger than age 40 and with no family history of eye disease. If a patient has had a clinical response to HCQ after 6 months, then a monitoring routine should be instituted. Patients with abnormal renal function or those who have received HCQ for more than 10 years require more frequent ophthalmologic evaluation. In the absence of risk factors, it is recommended that an ophthalmologic examination and central field testing be performed every 6-12 months. The central 10[degree] of the visual field is the initial site of antimalarial retinal toxicity. An Amsler test or a modified Amsler test can be used to screen for this early abnormality (35). This can be administered by self-testing if the patient is reliable, or by the patient's primary physician, to augment formal ophthalmologic testing.

    14. ).).

    18. CICLOSPORINA

    19. CICLOSPORINA: EFFETTI AVVERSI CAUSA DI SOSPENSIONE

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    42. II

    45. Agonista del recettore muscarinico dell’acetilcolina ( cevimelina 20 mg x 3 die.) Plaquenil: solo studi retrospettivi, non caso-controllo, difficile valutare l’efficacia poiché non disponibili scale di attività di malattia. Migliora stato generale e sintomi articlari, riduce autoab e Ig Ciclosporina abasse dosi non efficace, solo case reports isolati. CyA topica non disponibile in ItaliaAgonista del recettore muscarinico dell’acetilcolina ( cevimelina 20 mg x 3 die.) Plaquenil: solo studi retrospettivi, non caso-controllo, difficile valutare l’efficacia poiché non disponibili scale di attività di malattia. Migliora stato generale e sintomi articlari, riduce autoab e Ig Ciclosporina abasse dosi non efficace, solo case reports isolati. CyA topica non disponibile in Italia

    48. GESTIONE DEL PAZIENTE CON LES

    49. INFORMAZIONE SEMPLICE E CORRETTA SUL LES RICONOSCIMENTO FLARES INFORMAZIONE ED ACCETTAZIONE DELLA TERAPIA RAPPORTO CON FAMILIARI ASSOCIAZIONI DI MALATI PSICOLOGO EDUCAZIONE E SOSTEGNO

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    51. TRATTAMENTO FARMACOLOGICO

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