Systemic lupus erythematosus corticosteroids

Other rheumatic diseases in which the corticosteroids potent anti-inflammatory effects may be useful include vasculitis, systemic lupus erythematosus, Wegener s granulomatosis, psoriatic arthritis, giant cell arteritis, sarcoidosis, and gout. 

Chau SY, Mok CC. Factors predictive of corticosteroid psychosis in patients with systemic lupus erythematosus. Neurology 2003 61 104-7. 

Ettinger WH Jr, Hazzard WR. Elevated apolipoprotein-B levels in corticosteroid-treated patients with systemic lupus erythematosus. J Clin Endocrinol Metab 1988 67(3) 425-8. 

Zonana-Nacach A, Barr SG, Magder LS, Petri M. Damage in systemic lupus erythematosus and its association with corticosteroids. Arthritis Rheum 2000 43(8) 1801-8. 

Pryor BD, Bologna SG, Kahl LE. Risk factors for serious infection during treatment with cyclophosphamide and high-dose corticosteroids for systemic lupus erythematosus. Arthritis Rheum 1996 39(9) 1475-82. 

The role of both T and B lymphocytes in a variety of disease states beyond transplantation has become increasingly important in the past decade. This is especially true of those diseases frequently referred to as autoimmune in their etiology, such as rheumatoid arthritis, nephrotic syndrome, systemic lupus erythematosus, inflammatory bowel disease, and so on. In addition, several other major diseases are also known to have a component of T- or B-cell-mediated pathogenesis, for example, atopic dermatitis, psoriasis, and asthma. Until very recently, the mainstay of therapy for these diseases was the corticosteroids, which were often less than satisfactory in efficacy and often associated with undesirable side effects, especially in growing children and the elderly. Thus, the search for new agents with different mechanisms of action and which did not have the same adverse event profile as conventional corticosteroids led to the subsequent evaluation of drugs such as tacrolimus and sirolimus to treat several of these diseases. 

Corticosteroids are commonly used to reduce inflammation (innate immunity), treat autoimmune diseases such as systemic lupus erythematosus (SLE), and as a prophylactic measure to prevent transplant rejection. The adrenocorticosteroid prednisone is often coadministered with other immunosuppressives such as cyclosporine and azathioprine [36]. 

Even in the drug-induced forms of systemic lupus erythematosus, the reaction may last weeks, months and even years, with the necessity of continuing a maintenance dose of corticosteroids during this long period, e. g. 5.0-12.5 mg/day prednisone (Hoigne et al. 1975). 

Another woman with a previous history suggestive of lupus erythematosus developed a widespread flare in her skin 1 week after starting oral terbinafine (57). The eruption ultimately responded to systemic treatment with corticosteroids. 

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