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Suffering from SLE with ANA, diagnosed with mennoherrggia, brain hemorrhage, developed seizures, bacterial infection, ecoli. Help?

Patient name is Gurpreet Kaur, She is 25 yrs old female suffering from SLE with ANA +ve from since 2005.
Aug –Sep 2005- SLE with APS diagnosed with mennoherrggia –heavy menstrual periods- controlled by steriods
Dec 2007- Brain hemorrhage –operated for removal of clots from brain. Developed seizures after that.
Aug 2012 – acute attack of SLE- Swelling in joints-managed by steroids
Feb 2013-started with eye infection, then diagnosed with ecoli- bacterial infection. After that severe fever in range og 101-102 with chills. Developed cough and problem with breathing. Managed with antibiotics and steriods
Asked On : Fri, 22 Mar 2013
Answers:  1 Views:  22
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Orthopaedic Surgeon 's  Response
As a general guideline,steroids are necessary in acute episodes of SLE-but prolonged use has to be juidicious in view of brain hemmorhage, menorraghia history of Ms. Kaur
Now since shehas more of arthritic syptoms,her rheumatologist may think of substituting steroids with other biologics as and if affordable, as the price is enormous of certain biologics.
---Well your treating rheumatologist is the best judge.
Personally, I would now substitute steroids with non biologic 'disease modifying anti-rheumatic drugs'(DMARDS) Certain periodic blood tests are conducted before starting these,seeing past complications of SLE disease treated with steroids. (sometimes steroids are life saving' in acute emergencies and are definitely indicated for treatment of SLE, so giving steroid may have been inevitable in Ms. Kaur's case)
If the patient can visit rheumatologists at AIIMS New-Delhi, it would be worth seeking an opinion.
Answered: Fri, 22 Mar 2013
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