Confession of systemic lupus erythematosus

I won't beat around the bush in my opening remarks. Let me introduce myself. I am the famous systemic lupus erythematosus, or "Lupus" for short. There is a "wolf" in my name. Yes, I am just like my name - I am fierce, domineering, belligerent, and I admire the use of force. I am very destructive and violent. I prefer female patients between 20 and 40 years old. Of course, I also treat young children, the elderly, and men. Therefore, I also have a terrible nickname, "Immortal Cancer".

I once ran amok in the human system

I like to wander around in all parts of the human body. I start as a lurker. When the time is right, I will first give people a low-grade or high-grade fever, making them weak. Then I will find the skin and mucous membranes and trick them into becoming more beautiful with my help. This fool actually agreed to let me put makeup on it. Then, butterfly-shaped red spots will appear on people's faces.

I then went to the nervous system, causing migraines, personality changes, cognitive impairment, mood disorders... I made people mentally abnormal, all because of me! Then, I would go to the blood system, picking on the red blood cells, causing people to suffer from anemia; I also went to the joints and muscles, causing them to ache and swell, and be miserable; when I went to the kidneys, they were already trembling, begging me to let them go, which was a beautiful thought, I would not be soft-hearted. With my heavy punches, I created a "tragedy" in the kidneys - proteinuria, hematuria, and casts of urine were my masterpieces.

Many medical professionals want to find out the mechanism of my illness, but unfortunately I am so cunning that they return empty-handed. I just enjoy the pleasure of being able to do whatever I want in the human system. How do you say that? Yes, it is "I just like the fact that you can't stand me but I can't get rid of me"!

I'm suffocated by all the drugs

Medical workers couldn't kill me, so they tried to imprison me. They found a drug to control me, and my hard days began -

They asked for hydroxychloroquine to help, and asked patients to take the drug for a long time, which reduced my mobility, made me slow and clumsy, reduced organ damage and the risk of thrombosis, improved blood lipids, and significantly increased my survival rate. However, the price of trapping me is often accompanied by danger. Patients who take hydroxychloroquine for a long time or have liver and kidney diseases are very likely to induce retinopathy. Therefore, they have to undergo eye examinations every year before and after taking the drug.

When medical professionals found that hydroxychloroquine or nonsteroidal anti-inflammatory drugs were no longer able to control me, they asked for glucocorticoids to help. Small doses of the hormone prednisone can control my mild activities; for patients with serious conditions, large doses of hormone shock therapy are sometimes used. However, hormones are also a "double-edged sword". They can cause stomach discomfort, excitement, palpitations, insomnia, etc. Long-term use can also cause brittle fractures and increased blood sugar. In order to suppress my activities, the use of hormones needs to increase or decrease the dosage according to my level of activity and the occurrence of adverse reactions. The reduction process must be gradual and slow, and the drug cannot be stopped suddenly.

With the continuous progress of science, medical workers have found immunosuppressants, such as cyclophosphamide, leflunomide, methotrexate, tacrolimus, cyclosporine, etc., which came to the rescue when hormones combined with hydroxychloroquine could not suppress me. Different immunosuppressants have different focuses - cyclophosphamide is used for moderate to severe lupus nephritis and neuropsychiatric lupus; leflunomide is used to treat proliferative lupus nephritis; methotrexate is used for patients with mild to moderate non-renal lupus involvement... Therefore, when choosing immunosuppressants, doctors will comprehensively select drugs to deal with me based on factors such as the type of organ involvement, clinical manifestations, and drug safety.

When hormones and immunosuppressants can't do anything to me, biological agents come into play! Why do humans always find ways to make me bow my head? It can significantly reduce my activity, allow patients to completely or partially relieve symptoms, and reduce the amount of hormones used. Recently, the world's first dual-target biological new drug, Taitasip, was launched in China. For me, this is a super powerful weapon.

Humans actually have a set of secrets to prevent "wolves"

In addition to developing so many drugs to imprison me, humans have also summarized a set of anti-"wolf" secrets to allow patients to eliminate all things that are friendly to me:

1. Sun protection The sun will most likely bring me back to the light of day, so lupus patients have learned to carry an umbrella, wear a mask, sunglasses, and long sleeves when going out.

2. Avoid contact with harmful chemicals In order to prevent me from making a comeback, they try to avoid contact with certain cosmetics containing chemicals, such as hair dyes, eyebrow tattoos, etc.

3. Vitamin D Supplementation In order to reduce my activity level, they also supplement vitamin D appropriately to prevent osteoporosis.

Alas! I feel that the future is dark, but lupus patients are moving towards the light step by step!

Author: Wu Junli, pharmacist at Wuhan Wuchang Hospital

Review expert: Wei Guoyi, chief pharmacist of Beijing Anzhen Hospital affiliated to Capital Medical University