Management

• appropriate explanation, support and reassurance, use of sunscreens

• refer to consultant for shared care

• drug treatments o mild: NSAIDs (for arthralgia)

o moderate (esp. skin, joint serosa involved): low-dose antimalarials, e.g.

hydroxychloroquine up to 6 mg/kg once daily o severe: corticosteroids are the mainstay immunosuppressive drugs, e.g. azathioprine

• avoid drugs in those in clinical remission and with normal complement levels

• other treatments such as plasma exchange and immunosuppressive regimens available for severe disease

fever degression ma I ai

Eye disorders nrlammatmn net:iTLjl vasculitis

Shir butterfly rash \ photosensitivity j urticaria purpum discoid rash

Clie st pleuritis sffusien

Renal disorder glomerulonephritis prote nuria O.E g/day

Arthritis mainly P[P joints cf nand

Tendonitis

Avascular necroEiE,. e.g. femoral head alopecia

Avascular necroEiE,. e.g. femoral head

Nervo u 5 system seizures ataxia psychoses headache (intractable) cranial nerve lesions mouth ulcere lymphddenopathv

Cardiac pericarditis endocarditis splenomegaly abdominal pain ^isynaLd's pienomenon nail-fokl hyperatnua myalgia (rriusde pam)

_ periphere neuropathy

Arthritis small lonts or feet

Fig. 28.2 Clinical features of SLE

Arthritis small lonts or feet

Fig. 28.2 Clinical features of SLE

Nervo u 5 system seizures ataxia psychoses headache (intractable) cranial nerve lesions mouth ulcere lymphddenopathv

Cardiac pericarditis endocarditis splenomegaly abdominal pain ^isynaLd's pienomenon nail-fokl hyperatnua myalgia (rriusde pam)

_ periphere neuropathy

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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