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CONSTITUTIONAL SYMPTOMS. Reassurance Rest/exercise NSAID Antimalarials Steroids (e.g. Prednisone < .25 mg/kg/day) DHEA TCA/SSRI/Behavioral or cognitive therapy. CUTANEOUS. Sun avoidance/sunblock Steroids (topical and intralesional) Hydroxychloroquine (plaquenil) Chloroquine (aralen)
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CONSTITUTIONAL SYMPTOMS • Reassurance • Rest/exercise • NSAID • Antimalarials • Steroids (e.g. Prednisone < .25 mg/kg/day) • DHEA • TCA/SSRI/Behavioral or cognitive therapy
CUTANEOUS • Sun avoidance/sunblock • Steroids (topical and intralesional) • Hydroxychloroquine (plaquenil) • Chloroquine (aralen) • Quinacrine (atabrine) • Dapsone • Retinoids (isotretinoin) • Clofazamine • Azathioprine
ARTICULAR • NSAID • Antimalarials (HCQ, CQ) • Methotrexate • Azathioprine • Steroids (e.g. Prednisone < .25 mg/kg/day)
HEMATOLOGIC (AIHA/AITP) • Steroids (e.g. Prednisone 1 mg/kg/day; Decadron 40 mg day x 4 days) • Danazol • Dapsone • Vincristine • Cyclophosphamide • Intravenous immunoglobulin (IVIG) • Splenectomy • CSF (Epogen, Neupogen)
SEROSITIS • NSAID (e.g. Indomethacin) • Antimalarials (HCQ, CQ) • Steroids (e.g. Prednisone < .5 mg/kg/day) • Aspiration
VASCULITIS • Steroids (e.g. Prednisone 1 mg/kg/day) • Cyclophosphamide • Plasmapherisis (especially TTP/TMHA) • Intravenous immunoglobulin (IVIG)
Current Management of Lupus Glomerulonephritis Steroids oral daily or QOD Pulse solumedrol Cyclophosphamide Azathioprine Cyclosporine Methotrexate Plasmapheresis synchronized Intravenous gammaglobulin Mycophenolate mofetil 2 chlorodeoxyadenosine Fludarabine Recombinant human DNAse NSAID ACE inhibitors Low protein diet
NERVOUS SYSTEM • Steroids (e.g. Prednisone 1 mg/kg/day) • Cyclophosphamide • IVIG • Psychotropics (e.g. Haloperidol) • TCA/SSRI