Lupus erythematosus taking steroids side effects

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 25, 2024
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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.

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Written by Liu Li Ning
Rheumatology
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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What causes lupus erythematosus?

The cause of lupus erythematosus is not yet very clear. It is generally believed that the disease is caused by a combination of factors including genetics, environment, estrogen levels, and drugs, leading to immune disorder and consequently the onset of this disease. Studies have found that factors directly related to the onset of lupus erythematosus include ultraviolet rays causing apoptosis of epidermal cells, exposure of new antigens becoming autoantigens, and infections; Other possible related factors include drugs such as hydralazine and isoniazid, as well as food dyes, hair dyes, celery, figs, mushrooms, smoked foods, psychological stress, etc.; it may also be related to factors such as tobacco, vinyl chloride, asbestos, and vaccinations.

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Written by Liu Li Ning
Rheumatology
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Where does lupus erythematosus generally appear?

Lupus erythematosus can appear on various parts of the body. The most typical rash is the butterfly rash on the face, but it can also appear on other parts, such as discoid lupus, annular erythema, periungual erythema, and livedo reticularis. Additionally, systemic lupus erythematosus affects not only the skin and mucosa but can also involve the lungs, kidneys, heart, central nervous system, and other systems. Common manifestations include lupus nephritis and lupus pneumonia. The precise pathogenesis of systemic lupus erythematosus is still unclear. If the damage is confined to the skin and mucosa, immunomodulators such as hydroxychloroquine can be used for treatment. If important organs are involved, it generally requires long-term maintenance treatment with corticosteroids combined with immunosuppressants to control the progression of the disease.