All of the following are indications for use of coicosteroids in SLE except;
Correct Answer: Endocarditis
Description: It has not been proven that glucocoicoid or other immunosuppressive therapies lead to improvement of lupus myocarditis or endocarditis If diffuse proliferative glomerulonephritis (DPGN) is inadequately treated, viually all patients develop ESRD within 2 years of diagnosis. Therefore, aggressive immunosuppression is indicated (usually systemic glucocoicoids plus another immunosuppressive drug), unless damage is irreversible. Neuropsychiatric systemic lupus erythematosus (NPSLE) It is a generic definition referring to a series of neurological and psychiatric symptoms directly related to systemic lupus erythematosus (SLE). In NPSLE patients, although coicosteroids are commonly used when NPSLE is thought to reflect an inflammatory process, this practice can only be substantiated by clinical experience.NP disturbances have been related to the use of glucocoicoids. For example, approximately 10% of patients treated with 1mg/kg/day or more of prednisone will have a glucocoicoid-induced psychiatric disease. Depression, hypomania, and ove psychosis are known glucocoicoid-induced psychiatric manifestations. Symptoms usually occur within 8weeks of initiation or augmentation of glucocoicoids and resolve completely in most cases through dose reduction, which may help in the differentiation with NPSLE The pericardial friction rub of pericarditis resolves with steroids
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