When a stable patient with lupus erythematosus shows these signs, it's time to be alarmed!
Active systemic lupus erythematosus (SLE) usually tends to go into remission after treatment with hormones and other treatments, and the condition is stable (in remission). Because there is no cure, the disease changes from stable to active under the influence of certain triggers, such as infection, pregnancy, surgery, exertion, and drug withdrawal.
SLE is currently an incurable rheumatic immune disease, and certain triggers can also cause recurrence in patients with stable disease.
From a clinical point of view, a patient in remission should be considered for disease recurrence if he or she has the following symptoms and abnormalities on laboratory tests.
1. Unexplained fever: that is, fever cannot be explained by cold, pharyngeal, lung, urinary tract infection, etc., and is not caused by other diseases;
2. Fresh rash reappears or is accompanied by a vasculitis-like rash on the finger (toe) or other parts;
3. Recurring of joint pain;
4. Obvious hair loss;
5. Fresh nasal ulcers;
6. Pleural effusion or pleural effusion;
7. Increased proteinuria;
8. Leukopenia or thrombocytopenia or anemia is obvious;
9. Neurological symptoms: such as headache, vomiting, convulsions;
10. Increased titer of anti-double-stranded DNA antibody;
11. The erythrocyte sedimentation rate is increased, more than 50mm/h;
12. Complement decline, especially C3 decline;
13. Combined with the medical history and detailed physical examination, it is generally not difficult to make a judgment of disease recurrence. Complement C3 and anti-double-stranded DNA antibodies are often laboratory indicators of SLE activity. Therefore, in order to detect changes in the condition in time, patients with fever should go to the hospital for examination in time. Doctors ask patients to have their blood checked regularly in order to detect changes in their condition early.
The causes of recurrence are clear, such as abrupt discontinuation or rapid hormone reduction, or overexertion, sun exposure, etc. A farmer patient had recurrences of lupus after the summer or autumn harvest every year; Some recur during pregnancy or after childbirth. The causes of recurrence are sometimes unknown.
It is important to note that other diseases must be excluded for recurrence of the disease, and that a positive or non-decreasing antinuclear antibody titer must not simply be considered a recurrence, as antinuclear antibodies are not necessarily parallel to disease activity. Headache and vomiting should not simply be considered to be a recurrence of lupus, an exacerbation, or a concomitant encephalopathy.
A patient who has been sick for many years does not follow the doctor's instructions to adjust his hormones on his own, and adds a few tablets of hormone as long as he is feeling unwell. After a headache and vomiting, he increased prednisone to 40mg per day, but he did not know that on the basis of long-term use of hormones and immunosuppressants for several years, his immune function was reduced, and he was easily co-infected, and he was confirmed to have cryptococcal meningitis through the cerebrospinal fluid of lumbar puncture, and was hospitalized for up to 8 months.
Therefore, seeking medical attention in time after the above symptoms appear, and early and reasonable control can benefit the most.