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

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