Management:
The patient started SLE treatment on 30/12/2020 after two months of her
initial symptoms. She was started on pulse steroid 1000 mg of
methylprednisolone daily for five days, followed by oral prednisone 60mg
daily. The patient was started on Plaquenil 400mg PO OD and
cyclophosphamide 2mg/Kg PO OD. She was prescribed phenytoin as an
antiepileptic medication. However, she developed an allergy to it, so
she was shifted on levetiracetam, became more agitated, turned to
Lamictal 25mg PO BID gradually, and weaned off levetiracetam, which made
her better in terms of agitation. She was prescribed Bisoprolol 5mg PO
BID for her sinus tachycardia. After three months, her medical situation
improved, with no more seizures or psychosis. On 08/06/2021,
cyclophosphamide was stopped, started on Cellcept 1000 mg PO BID, and
gradually reduced her steroid dose to 15mg PO OD. Since she was on
steroids, her weight increased, and her lipid profile revealed an
increase in total cholesterol and LDL, so she has been prescribed
atorvastatin and advised about diet. She had a thyroid antibodies test
and was negative, so she was advised to do FNA of the thyroid to check
for malignancy, and the biopsy results were unremarkable for malignancy.
At 02/03/2022 the patient was on prednisolone 5 mg PO OD, Cellcept 1000
PO BID , Plaquenil 400 mg PO OD , atorvastatin 10 mg PO OD , Lamictal 25
mg PO BID , Bisoprolol 5 mg PO PD, and Ca and vitamin D tablets. She had
no active complaints, and she was doing fine.