Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
136 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Suggest suitable remedy for rheumatoid arthritis

My wife has been diagnosed as SLE with Rheumatoid arthrits.Was being intially given methatroxate,HCCQ,SAZO,Volteren,.She took methatroxate for few months only as she did not tolrate it.Then predinisolone 10 mg was added to her treat ment.For last few months platelets started falling dowm gradually.But for last one month drop of platelets was quick,but gradual and reached to 43000 only.predinisolone was increased to 60 mg OD.Platelets increased quickly but after few day again started falling quickly and reached to 45000 .Then Methyl predinasolone 30mg 8 hourly was given by IV drip for three days and platelets increased again above one lack and pt.was again shifted to oral predinisolone 50 mg od.In the mean time all side effects of steroid appeared like swelling of face and body,increased appetite, acnae like rash on face and body,genelised lethargy[weakness] ,shortness of breath etc.but after few days platelets again started falling down quickly and reached to 43000 again.Now she has been given immunoglobulins 400mg/kg per day by Iv drip for five days and in the mean time predinisolone was reduced to 10 mg TId [30 mg od] and platelet count has increased to 112000 and pt will be revieweId on saturday again[after 2 days].I forget to mention that in addtion to all investigations Bone marrow was done which suggested the peripheral destruction of platelets[Thrombocytopenia due to SLE peripheral destruction].Steroid were started about one and half month back.She is also being given calcium,Vit.d tabs,Amlodipine 5 mg od from ffor last few months.She was also started azathioprine 50 mg od for last 2-3 days.

Now my question is that was this process and procedure a correct way of treating this problem ? and when will the adverse effects of steroids disappear ? and thirdly what adverse effects are expected from Immunogloblins.Presently she tolrated them well without any advese effects.Yesterday was given the final[5th]dose ? Is adding Azathioprine a correct decision ? Finally it is requested to let me know is there any other safer teatment available for SLE and where[I mean in India] ?

Thank sir.

Dr.Nasir

YYYY@YYYY
Wed, 4 Mar 2015
Report Abuse
Orthopaedic Surgeon 's  Response
Thank you for the question.Adding azathioprine as an immunosuppresant is likely to help as the patient is on steroids since long.I would suggest the patients kidney function/status should be simultaneously assessed for any nephritis also to rule out.
Use of sun protective screens and clothing to avoid flares of SLE.
I would suggest to continue HCQ if patient tolerates well.
eating Pappaya is said to help improve platelets, as many doctors in India have recommended .,although no special diet regime has yet to form guidelines by rheumatologists
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Related questions you may be interested in


Recent questions on Immunosuppression


Suggest suitable remedy for rheumatoid arthritis

Thank you for the question.Adding azathioprine as an immunosuppresant is likely to help as the patient is on steroids since long.I would suggest the patients kidney function/status should be simultaneously assessed for any nephritis also to rule out. Use of sun protective screens and clothing to avoid flares of SLE. I would suggest to continue HCQ if patient tolerates well. eating Pappaya is said to help improve platelets, as many doctors in India have recommended .,although no special diet regime has yet to form guidelines by rheumatologists