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Liu Li Ning
Rheumatology
About me
Graduated from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, with a Master's degree. Specializes in various rheumatic diseases, especially proficient in dealing with complex rheumatic conditions.
Proficient in diseases
Rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, Behçet's disease, Sjögren's syndrome, scleroderma, osteoarthritis, etc.
Voices
Can women with lupus erythematosus have sexual intercourse?
Women with lupus can engage in sexual activity. Sexual activity itself does not affect systemic lupus erythematosus, but it is essential to use contraception. It is recommended to use condoms for contraception. The use of contraceptive pills or withdrawal method is generally not recommended. This is because, in case of an unplanned pregnancy, there could be a risk of triggering a flare-up of the disease. Moreover, the risk of miscarriage or embryonic developmental arrest in pregnant women with lupus is much higher than in healthy individuals. If there are plans for pregnancy, it should only be considered after the disease has been stable for more than six months. During pregnancy, it is crucial to follow medical advice strictly regarding medication and to regularly undergo prenatal screening.
How to quickly relieve rheumatic fever pain?
Rheumatic fever pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) for rapid pain relief. NSAIDs are the first-line medications for treating rheumatic fever pain. Commonly used ones include diclofenac sodium sustained-release capsules, etoricoxib, meloxicam, or etodolac. These medications may cause gastrointestinal discomfort, so they cannot be used by patients with active peptic ulcers. If there are contraindications to using NSAIDs, pain relief can be achieved with medications such as tramadol or Aconitum alkaloid tablets. If rheumatic fever is accompanied by carditis, treatment with corticosteroids is also necessary. Since the onset of rheumatic fever is related to streptococcal infections, the use of penicillin antibiotics for anti-infection treatment is also recommended.
What is lupus and is it serious?
Lupus erythematosus is an autoimmune disease, which can be very severe in some cases and mild in others. For example, cutaneous lupus erythematosus generally does not involve major organs and usually presents with mild symptoms, primarily affecting the skin and mucous membranes. However, systemic lupus erythematosus can affect significant organs like the kidneys and heart in many patients, often leading to severe medical conditions. Especially, patients with rapidly progressive glomerulonephritis and those with coronary atherosclerotic heart disease tend to have a higher mortality rate. If systemic lupus erythematosus is diagnosed, it is crucial to receive standardized treatment early. Typically, treatment involves long-term maintenance with corticosteroids and immunosuppressants to control the progression of the disease and reduce the likelihood of mortality.
How should rheumatoid arthritis be treated?
The treatment of rheumatoid arthritis includes several aspects. First, general treatment: keep a light diet, avoid spicy and stimulant foods, ensure joints are kept warm, and avoid excessive fatigue. Second, medication treatment: during acute flare-ups, non-steroidal anti-inflammatory drugs such as diclofenac sodium or etoricoxib can be used, possibly combined with low doses of corticosteroids. During stable phases, immunosuppressants such as methotrexate or leflunomide are needed. If conventional treatments are ineffective, biological agents like adalimumab or tofacitinib can be combined. Most patients can effectively control their condition after combined treatment. Third, traditional Chinese medicine: alongside Western medicine, Chinese herbal medicine such as total glucosides of paeony or tripterygium wilfordii polyglycoside can be used.
What does the early rash of lupus look like?
The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.
Can rheumatoid arthritis be cured through exercise?
Rheumatoid arthritis can be somewhat alleviated by exercise in terms of disease recovery. Rheumatoid arthritis primarily manifests as migratory swelling and pain in the major joints throughout the body. The onset of the disease is somewhat associated with streptococcal infections. In recent years, due to the widespread use of penicillin, rheumatoid arthritis has become very rare in clinical settings. Since the onset of rheumatoid arthritis is related to infections, long-acting penicillin is generally used for treatment if there is no accompanying carditis. Joint pain can be treated with non-steroidal anti-inflammatory drugs such as etoricoxib or sustained-release capsules of diclofenac sodium; if carditis is present, corticosteroids can be used. Patients with rheumatoid arthritis can engage in gentle aerobic exercises like swimming, yoga, jogging, Tai Chi, etc.
Does lupus erythematosus transmit through living and eating together?
Lupus erythematosus is not contagious through sharing meals or living together. It is an autoimmune disease, not an infectious one, hence it cannot be transmitted to others by living or eating together. The exact mechanism of lupus is currently unclear, but it may be related to various factors such as sex hormones, genetics, infections, and physical and chemical factors, and it is more commonly seen in females. Clinically common symptoms include fever, rash, joint pain, oral ulcers, hair loss, etc. The clinical manifestations vary depending on the affected target organ. If lupus nephritis occurs, symptoms such as edema can appear. If the lungs are involved, it can promote pulmonary interstitial fibrosis, and in severe cases, patients may experience chest tightness, shortness of breath, and breathing difficulties.
Can rheumatic fever be contagious?
Rheumatic fever generally is not contagious. Because the onset of rheumatism is somewhat related to infection by Group A beta-hemolytic streptococcus, and it is not a contagious disease, it does not spread. Common clinical manifestations of rheumatic fever include fever, erythema marginatum, subcutaneous nodules, joint pain, chorea, and carditis. During the acute phase of rheumatism, it is recommended to rest in bed and avoid overexertion. In terms of medical treatment, because it is related to streptococcal infection, penicillin antibiotics are generally recommended. If there is concurrent carditis, corticosteroids should be used in combination to improve the condition.
What should I do about lupus erythematosus?
Lupus erythematosus requires early and formal treatment to stabilize the condition. For mild cutaneous lupus erythematosus, topical immunosuppressants, such as tacrolimus ointment, and immunomodulators, such as hydroxychloroquine, can be used. Low-dose corticosteroids may be necessary for combination therapy. Systemic lupus erythematosus generally requires corticosteroids as the basis of treatment, combined with one or several immunosuppressants to effectively control the disease. Systemic lupus erythematosus often involves multiple organs, with the kidneys, hematological system, and lungs being the most common. Therefore, it is necessary to use corticosteroids in combination with immunosuppressants to control the progression of the disease, as using only immunomodulators is often insufficient.
Do you need to take X-rays for rheumatoid arthritis?
Rheumatoid arthritis requires imaging, especially of the affected joints. It is typically necessary to do this routinely. The main purpose is to check for any bone damage, primarily to differentiate it from rheumatoid arthritis. Because rheumatoid arthritis generally does not leave joint deformities, while rheumatoid arthritis, if not treated properly, can lead to bone destruction and in severe cases, joint fusion. In addition to imaging, rheumatoid arthritis also requires complete blood count, erythrocyte sedimentation rate, C-reactive protein, anti-streptolysin O, and echocardiography among other tests to comprehensively assess the condition and determine the treatment plan.