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21
Zhang Lin
Rheumatology and Immunology Nephrology
About me
Dr. [Name], Associate Chief Physician at The Fourth Hospital of Changsha City.
Graduated from the Xiangya Medical College of Central South University, with over twenty years of experience in nephrology and rheumatology immunology. Has been involved in clinical, teaching, and research work, co-authored 1 monograph, participated in multiple national and provincial projects, and published over ten academic papers, two of which were included in SCIE.
Currently serves as the Director of the MDT Research Laboratory at the Changsha City Digestive Surgery Institute, Associate Chief of Nephrology and Rheumatology Department at The Fourth Hospital of Changsha City, member of the Quality Control Committee, Medical Accident Appraisal Committee, and Academic Committee of The Fourth Hospital of Changsha City, as well as a member of the Changsha Municipal Committee of the Chinese People's Political Consultative Conference.
Proficient in diseases
Diagnosis and treatment of acute and chronic kidney disease, as well as secondary kidney disease, and rescue of critical conditions
Voices
Can lupus patients get pregnant?
Patients with lupus can conceive normally, but it is not recommended to become pregnant. This is because patients with lupus who become pregnant are prone to miscarriage, preterm birth, stillbirth, and poor fetal development in the uterus, especially in patients who are positive for antiphospholipid antibodies. Pregnancy can also aggravate the disease or cause a relapse in lupus patients, and even if the disease is stable, there are cases where the condition worsens during pregnancy or after childbirth. Therefore, it is not recommended for patients with active systemic lupus erythematosus to become pregnant. If the condition has been stable for more than a year after treatment and the patient has been off medication for at least 6 months, then pregnancy can be considered. However, it is important to note that dexamethasone, immunosuppressants, and Tripterygium wilfordii tablets have side effects on the fetus and should be avoided.
What should I do about lupus joint pain?
In patients with systemic lupus erythematosus, most suffer from arthralgia. The joint pain caused by systemic lupus erythematosus is due to the deposition of immune complexes in the joint cavity, or inflammation of the blood vessels nourishing the joints. This primarily manifests as joint swelling and pain, and often occurs symmetrically. When joint pain occurs in lupus, in addition to corticosteroid therapy, we can also use non-steroidal anti-inflammatory drugs (NSAIDs) under the guidance of a doctor. These drugs can achieve good analgesic and anti-inflammatory effects. However, patients with renal insufficiency should use these drugs with caution.
What are the symptoms of a lupus flare-up?
After treatment with steroids and other therapies, active lupus erythematosus usually improves and enters a stable phase. However, factors such as infection, pregnancy, surgery, fatigue, and discontinuation of medication can trigger the transition from a stable phase back to an active phase of lupus erythematosus. The following symptoms should be considered for a possible recurrence of the disease: First, onset of fever without reasons related to colds or infections. Second, appearance of new rashes or vascular-like rashes on fingertips and other areas. Third, recurrence of joint swelling and pain. Fourth, significant hair loss. Fifth, development of fresh ulcers in the mouth or nose. Sixth, development of fluid accumulation in the chest cavity or pericardium. Seventh, increased protein in urine, decrease in white blood cells or platelets, or significant anemia.
Can lupus be inherited?
Lupus erythematosus is not a genetic disease, but it is a disease with a genetic predisposition. This means that genetic diseases refer to monogenic diseases, including albinism, color blindness, etc., which are determined by a pair of alleles. However, lupus erythematosus is a disease with a genetic predisposition, determined by multiple genes. Although lupus erythematosus is not a genetic disease, if your parents have lupus erythematosus, the chance of the next generation developing lupus erythematosus is about 1% to 16%. This relationship is especially significant between mothers and daughters, and among sisters. Genetic factors account for approximately 20% of the importance in the development of lupus erythematosus. Only the combination of genetic factors and environmental factors together can lead to the occurrence of lupus erythematosus.
Does lupus cause itchy skin?
The rash in patients with lupus erythematosus is generally not noticeably itchy. In patients with lupus erythematosus, the characteristic changes include a butterfly-shaped rash on the bridge of the nose and cheeks. The skin lesions of lupus erythematosus include photosensitivity, hair loss, erythema on the palms and soles and around the nails, discoid lupus, nodular erythematosus, seborrheic dermatitis, livedo reticularis, and Raynaud's phenomenon, among others. Generally, there is no noticeable itching. If significant itching occurs, it suggests an allergy. Itchy rash after immunosuppressive treatment should be monitored for fungal infections. Lupus patients receiving steroid and immunosuppressive therapy, if experiencing unexplained localized skin burning, may be showing early signs of herpes zoster and should seek prompt medical attention at a hospital.
Lupus erythematosus taking steroids side effects
Patients with lupus mainly use steroid treatment, but steroids have many side effects during their application, such as increased blood pressure, inducing or exacerbating infections, inducing or aggravating peptic ulcers, necrosis of the femoral head, osteoporosis and vertebral compressive fractures, delaying wound healing in injured patients, increasing blood sugar, etc. Additionally, steroids can cause nervous sensitivity, agitation, insomnia, emotional changes, and even apparent mental symptoms, inducing seizures such as epilepsy. Some patients may also have suicidal tendencies. Therefore, it is necessary to use medication rationally under the guidance of a doctor, reduce the dosage timely, and effectively prevent and treat to minimize the occurrence of side effects. Taking steroids can also lead to weight gain; hair loss is relatively less common. The occurrence of side effects varies among individuals and should be tailored to the patient's specific condition.
Can people with lupus eat beef?
For patients with lupus, we recommend eating less beef. This is because our dietary guidelines for lupus patients are: high protein, low fat, low salt, low sugar, and foods rich in various vitamins and calcium. Since beef is a high-phenylamine protein food, it is advised to consume less of it. Patients can eat some fish, lean meat, chicken, and duck, depending on their financial situation, to supplement the protein lost in the kidneys but should not eat too much to avoid indigestion. The diet for lupus patients should be light, and when cooking, food should not be too oily or too spicy.
Can people with lupus eat mangoes?
For patients with lupus erythematosus, we recommend caution in consuming mangoes. Mangoes are among the fruits that commonly cause allergies. After allergic reactions, most people develop rashes, and skin redness is a symptom of lupus erythematosus. If an allergy is triggered, it can worsen the redness and may also be confused with the rash associated with lupus patients. We can eat some grapes, as grapes are a nourishing food that promotes health and longevity. We can also eat some watermelons, which are rich in water and act as a natural nutrient solution, containing various nutrients. However, the intake of food should not be excessive.
What foods are good for lupus erythematosus?
The diet for patients with lupus erythematosus varies from person to person. Generally, the ideal food for lupus patients should have the following characteristics: an appropriate amount of high-quality protein, low fat, low salt, low sugar, and rich in vitamins and calcium. Since many lupus patients often have significant kidney damage, proteins are frequently lost in large amounts through the urine, causing hypoalbuminemia and edema. The supplementation of protein should primarily consist of high-quality animal proteins, such as milk, eggs, and lean meats. However, protein intake should also be appropriate and not excessive. Excessive intake can not only lead to incomplete absorption by the patient, increasing the burden on the gastrointestinal tract, but also increase the excretion of nitrogenous compounds in the body, further burdening the kidneys. Lupus patients should avoid or minimize consumption of foods that can enhance photosensitivity, such as figs, rapeseed, cilantro, and celery. If consumed, they should avoid sun exposure afterwards. Mushrooms, smoked foods, and certain food dyes can also trigger lupus and should be avoided or minimized in the diet.
What should I do if I have a fever with lupus erythematosus?
When patients with lupus experience fever, the fundamental approach is the use of ample steroids or other immunosuppressive drugs for treatment, which generally can quickly normalize body temperature. However, some patients may also experience fever during steroid use, possibly due to the steroids reducing immune function and inducing a bacterial infection. At this point, it is necessary to find evidence of infection and promptly treat with adequate sensitive antibiotics. Then, there will certainly be questions about why patients with lupus who have a fever cannot use antibacterial drugs or antipyretics. This is because fever in lupus patients is often an important indicator of disease activity. During acute phases, the fever is typically high, not caused by external infections, thus antibacterial drugs are ineffective. Using antipyretics can temporarily normalize body temperature, but once the effect of the medication wears off, the high fever may recur. Patients with lupus should not casually use medications. If medication is needed, it should be used under the guidance of a doctor.