Can Systemic Lupus Erythematosus destroy my child's bladder?
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Can you answer a question about SLE in a child. Starting at the onset of her menses she has had all kinds of weird symptoms that point to some type of autoimmune disorder. We have been to Mayo Clinic and many doctors in St. XXXXXXX We are looking for a top notch adult rheumatologist (having seen only pediatric rheumatologists from the time she turned 13 until now. Has anyone ever heard of lupus destroying the bladder? She is now 16 years old and we feel that maybe it is time to see someone who deals with adults and is extremely knowledgeable in the autoimmune, connective tissue disorders and lupus. Any help would be appreciated. XXXXXXX XXXX- the patient is my granddaughter.
Posted Sat, 25 Jan 2014 in General Health
Answered by Dr. Suleman Muhammad 7 hours later
Brief Answer: Autoimmune multiorgan involvement needs care Detailed Answer: Hi, I read your concern about your grand daughter's SLE presentation at such a young age. You don't sound sure about the diagnosis but the thing is all the autoimmune disorders are multiorgan involved illnesses and they need a detailed work up and a constant compliance with the medicine and a very good rheumatologist's touch in constant. I want you to know that despite constitutional symptoms Lupus can involve any organ like skin, lungs, Nervous system, kidneys, blood, hair and gut. So this multiorgan involvement needs a constant monitoring specially of end organs like kidneys and brains called lupus nephritis or cerebritis. Now as i said you would need alot of work up like AntiDS DNA, ANA, Antismith, blood profile histopathologies, radiologic work up and pleaural and joint fluids and gastro intestinal work up. So yes for sure you would need an adult rheumatologist. i will provide you a list of top notch rheumatologist at the end near you. Miss Mc Culoch, you should know that lupus or any other autoimmune disorder is not treatable, just manageable. So medicines will be life long and diet and lifestyle modifications would accompany like care in pregnancy or avoiding them etc. ANd you would not just need a rheumatologist but a team of Rheumatologist, Infectious disease specialist', Neurologist', Pulmonologist, Cardiologist, Gastroenterologist, Nephrologist, Dermatologist, Hematologist and High-risk obstetrician for the lupus or any other autoimmune disorder to be managed properly. DMards ,antimalarials, steroids NSAIDs, and constant monitoring of vital organs would be necessary. Now regarding your bladder query, so yes, bladder is close to kidneys and part of genitourinary tract so yes it can be effected too. I recommend XXXXXXX D. Brasington, MD You will find him in Center for Advanced Medicine Medicine Multispecialty Center 4921 Parkview Place, C, 5 St. XXXXXXX MO 63110 314-286-2635 Fax: 314-286-2338 or Medical Building Two Barnes-Jewish West County Hospital 10 Barnes West Drive, Suite 200 Creve Coeur, MO 63141 314-286-2635 Fax: 314-286-2338 He has been Listed in Best Doctors in XXXXXXX 2002-2013 (Best Doctors, Inc.) also Listed in America's Top Doctors, 2002-2012 (Castle Connolly Medical Ltd.) got Spirit of Giving Award, Arthritis Foundation Eastern Missouri Chapter 1998 also ownsAmerican Medical Association Physician's Recognition Award, 1988, 1991. command and trained and perfect your your granddaughter. But he sees patients only referred by physician not directly. But get in touch with them see if there is a way. Good luck and i hope every thing gets back to the way it was. If you have any more queries for me, please feel free to ask Other wise i request you to kindly close the discussion and rate the answer as per your experience. Regards Dr Suleman
Follow-up: Can Systemic Lupus Erythematosus destroy my child's bladder? 6 hours later
Thank you for your answer. We are aware of the care she needs that is why we went to the Mayo Clinic for treatment. She is now on plaquinal but her flares are becoming much more frequent. Her flares consist of blood in the urine and coughing up blood. There is no agreement on where the blood is coming from - kidney function is good and there is no evidence that the blood is coming from the kidney. Lungs are also good and there is not evidence that blood is coming from the lungs. She is also seeing a hemotolgist because she does test positive for MTMFR and Leiden Factor 5. So there are several things going on with her. I have an aunt and 2 cousins whe suffer from Lupus so I do understand everything that goes along with it. My concern is that no doctor with give the definitive diagnosis of Lupus. We are always told that she has lupus like symptoms. Her parents want her on a treatment plan that will help make the flares easier to deal with. Thank you again for your time.
Answered by Dr. Suleman Muhammad 23 minutes later
Brief Answer: Bleeding disorder aggrevates the condition, Detailed Answer: Hello Again Miss XXXX: Thank you again for asking. As I mentioned hematologist is also a part of the team needed to manage these lupus like symptoms. Now lupus like symptoms can be presented with many systemic diseses other than lupus like behcet. polyarteritis nodosa and many more. I want you to know that these flares mean the management is not sufficient. Plaquenil is a long acting drug ( hydroxyxhloroquine) but the thing is that the kid needs more than that. Let the rheumatlogist I recommended be the one to decide what is going on. Now the hemoptysis and hematuria is explained by blood disorder and hypercoagulable state of the kid. A full fledge monitoring of bleeding profile is necessary here under s supervision of concerned hematologist. We just need to connect the dots. and the plan i advised is required for that. So stop worrying and let the concerned team of specialists help you. Trust me I have seen worse resolving from flares. We just need the right plan. Every thing will be all right madam, Just hang in there and let the medicines show its effects guided by a rheumatologist. I will be here if you need me. May the odds be ever in your favour. Kindly don't forget to close the discussion if the queries are finished regards Dr Suleman
Follow-up: Can Systemic Lupus Erythematosus destroy my child's bladder? 4 hours later
This will be my last question. Given the circumstances of the paralyzed bladder starting at the same time these other symptoms started is there a chance that given the right medicications her bladder could start to function normally again or has too much damage already occured. She is now only able to urinate when she catheterizes herself. I do appreciate your information and we will have no problem getting in to see the doctor you recommended. Her peditrician will call him. The Mayo Clinic has already tried the inter-stim approach and it failed. Thank you again.
Answered by Dr. Suleman Muhammad 19 hours later
Brief Answer: Neurogenic bladder usually resolve. Detailed Answer: Hello again madam, Neurogenic bladders are always the victims of some aetiologies which once gotten rid of resolves the issue of Micturition. It will need bladder training exercises, some bladder muscles relaxants, some anticholinergics, some tricyclic antidepressants and a physiotherapist to get the bladder back on track and a good urologist. We need to nip the evil from its bud first, which is a systemic illness which needs management. I am sure you will be able to manage the disease once the issue is resolved and managed properly all the things including neurogenic bladder will get back to normal. My best wishes and prayers will follow your daughter. keep me posted about the kid and let me be a part of her management by being informed, as my patient is a lot of meaning to me. Take a very special care of your grand daughter and may you get the reward for this outstanding effort and endeavor for your kid. Regards Dr.Suleman