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Management approach for refractory SLE: A case study

By Haimanti Mandal

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Betty DiamondBetty DiamondWilliam StohlWilliam StohlMurray UrowitzMurray UrowitzRicard CerveraRicard CerveraManuel Francisco Ugarte-GilManuel Francisco Ugarte-GilLaurent ArnaudLaurent Arnaud

Sep 5, 2024

Learning objective: After reading this article, learners will be able to understand the management approach for refractory SLE.


During the Lupus Hub Steering Committee Meeting, held on May 7, 2024, Ricard Cervera chaired a discussion on a case study to understand the management approach for refractory systemic lupus erythematosus (SLE), with contributions from Betty Diamond, Murray Urowitz, Laurent Arnaud, William Stohl, and Manuel Francisco Ugarte-Gil.  

 

Management approach for refractory SLE: A case study


Cervera presented a case of a 34-year-old female with a 10-year history of lupus who was hospitalized due to left arm paresthesia and speech difficulties. Her past experience with lupus nephritis, prior treatments, and comorbidities were also noted. The discussions covered differential diagnoses at hospital admission, initial tests and procedures, subsequent treatments, and final diagnosis. Cervera also shared key findings from the Euro-Phospholipid project that guided his treatment approach. The steering committee addressed several questions, including adherence to antimalarials, effective control of lupus after treatment, appropriate dosage of hydroxychloroquine, impact of steroid treatment on blood pressure, and antiphospholipid antibodies testing during diagnosis. Opinions on alternative test procedures and treatments were also shared.