My sister has lupus. Since early December she began having hoarseness and severe pain to her larynx esophagus region. She described it as a razor slicing her voice box when beginning to speak or when stooping talking. She was put on ranitidine 1200mg initially. She has GERD and has in the past needed such a dose. When there was no real relief, she was put on Nexium. Although there was a slight relief, she continues to cough+++at nite even though she is sitting upright to sleep. Would there be any benefit to be taking raniditine or prednisone as well? She has had a scope done recently showing no lesions or tumors.