RESUMO
INTRODUCTION: Hematologic manifestations of Systemic Lupus Erythematosus (SLE) such as hemolytic anemia, leucopenia and thrombocytopenia are among the common causes of morbidity and hospitalization among patients. This is a case report of a patient presenting with refractory cytopenias.CASE: The patient is a 42-year-old female, diagnosed with SLE, having met the Systemic Lupus Erythematosus International Collaboration Clinics Criteria for diagnosis Persistent serositis (pleural effusion and ascites) and worsening of anemia prompted treatment with oral corticosteroid (prednisone 1.0 mg per kg per day) which showed improvement of shortness of breath and pleural effusion. Cytopenias persisted despite increasing IV pulse steroid to 6.0 mkd prednisone then further to 13 mkd prednisone.Rituximab given as 1.0 g infusion once every two weeks for two doses which resulted to improvement of anemia, thrombocytopenia and serositis. CONCLUSION: Hematologic manifestations may present as life threatening complications of lupus.Most cases are responsive to corticosteroid therapy,however,in a few refractory cases,less used conventional treatment such as rituximab,may provide significant response.
Assuntos
Humanos , Feminino , Adulto , Serosite , Prednisona , Rituximab , Leucopenia , Lúpus Eritematoso Sistêmico , Trombocitopenia , Lúpus Eritematoso Discoide , Anemia Hemolítica , Derrame Pleural , Corticosteroides , DispneiaRESUMO
OBJECTIVE: To obtain reference values of bone mineral density (BMD) for Filipino women in order to make a population-specific diagnosis of osteoporosis.SETTING: Osteoporosis Unit, Joint and Bone Center, Section of Rheumatology and Clinical Immunology, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines. PARTICIPANTS: 442 healthy Filipino women volunteers recruited from the outpatient department, Rheumatology and Clinical Immunology Clinic of the University of Santo Tomas Hospital and from within the University of Santo Tomas campus. Subjects with known underlying illness or conditions or intake of drugs that predispose to osteoporosis were excluded from the study. INTERVENTION: Bone mineral density (BMD) measurements, expressed in grams per square centimenter of the lumbar spine, non-dominant femur and non-dominant forearm were done in 442 consecutive healthy Filipino women using the LUNAR DPX-IQ machine. RESULTS: Means and standard deviations of BMD measurements at each site were calculated using Kwikstat software Version 3.6, Release 7. Results were grouped in decades to serve as reference per decade. CONCLUSION: BMD of these 442 healthy Filipino women may serve as an initial reference guide for the diagnosis of osteoporosis in Filipino women.