Since it is less common, many pregnant women are caught in surprise when they learned from their doctors that they are suffering from Sjogren's syndrome. It commenced the moment of constant worry and anxiety because the disease exposes their babies to higher risks for neonatal lupus, heart problems and even death. What is Sjogren's Syndrome exactly?

Sjogren's Syndrome and Its Symptoms
Sjogren's Syndrome is a type of autoimmune disease primarily characterized by the drying up of the eyes and the salivary gland which may lead to the dryness of immediate body parts that require moisture including the skin, throat, vagina and nose. Sjogren's syndrome may also affect the blood vessels, joints, lungs, digestive organs, nerves, liver, pancreas, brain and kidneys.

It primarily involves the inflammation of tissues and glands of the body. The swelling of the salivary gland usually results to cavities, dental decay, swallowing difficulties, mouth dryness, stones, mouth sores, infection of the parotid gland and mouth inflammation.

According to research, people with Sjogren's syndrome have deficiency in Omega 3 essential fatty acids, magnesium, zinc and selenium. Aside from the dryness of the mouth and eyes, some patients suffer from symptoms such as swollen parotid glands, recurrent mouth infection, eye discomfort, hoarseness, blurred vision and difficulty in eating and swallowing. It can also cause pain and fatigue which can affect the patient's quality of life.

What Is An Autoimmune Disease
When we say autoimmune diseases, it refers to the abnormal functioning of the immune system. Instead of helping the body fight against diseases, the immune system tends to attack the organs of the body. In Sjogren's Syndrome, the immune system attacks the salivary gland which produces saliva, and the lacriminal gland which produces tears. This eventually leads to the dryness of the eyes and mouth.

Risk Factors For Sjogren's Syndrome
According to research, this autoimmune disease can occur to people of all ages but it is more common to people who are over 40 years of age, and women are 9 times more susceptible to this condition compared to men.

Even people diagnosed with rheumatic diseases such as lupus or rheumatoid arthritis are at a greater risk of suffering from Sjogren's Syndrome.

Sjogren's Syndrome in Pregnant Women
Women who have been diagnosed with Sjogren's Syndrome should consult their doctors especially when they are planning to get pregnant. It can actually increase a woman's risk for miscarriage. Women who are suffering from this condition usually have antibodies known as antiphospholipids. It makes the blood more prone to clotting. Thus, miscarriage is more likely to occur when the blood in the placenta has clotted.

Many babies were lost during the course of pregnancy due to this condition. It actually causes the amniotic fluid to be filled with hardened crystal-type particles which can suffocate and kill the developing baby in the uterus.

In rare cases, this autoimmune disease can cause congenital heart block which is characterized by an abnormal heart rhythm or rate in infant. When this happens, doctors usually prescribe corticosteroid medications to reduce the inflammation.

Also, doctors have to carefully monitor the baby's condition throughout the pregnancy. According to research, congenital heart block sometimes necessitates early delivery. In very rare cases, Sjogren's syndrome increases the fetus' risk for heart problems. Also, it heightens the baby's susceptibility to lupus.

Treatment Options For Sjogren's Syndrome
In most cases, treatments for Sjogren's syndrome are directed towards providing relief to its symptoms. Some doctors recommend the use of eyedrops which can reduce the inflammation of the glands surrounding the eyes, in order to increase the production of tears. Frequent intake of water, saliva substitutes and chewing gum can also help in preventing the mouth from getting dry. Meanwhile, for nasal dryness, patients can use nasal saline irrigation and humidifiers.

Sucking on glycerine swabs and sugarless lemon drops can also help in inducing the production of saliva. Also, drinking plenty of fluid and getting adequate dental care can help in preventing mouth dryness. Saliva stimulants such as cevimeline and pilocarpine can also help in addressing dry mouth.

Surgery may sometimes be prescribed by doctors in order to seal the tear ducts which drain tears from the eyes. Silicone plugs or collagens are then inserted into the ducts for temporary closure. Eventually, collagen dissolves and silicone plugs are removed. In this case, doctors may recommend laser to seal the ducts permanently.

About the author:

Source: http://www.sooperarticles.com/health-fitness-articles/pregnancy-articles/sjogrens-syndrome-pregnancy-1084327.html


sle treatment in pregnancy

28 thoughts on “Sle Treatment In Pregnancy

  1. Shifty

    a woman i know has NO amniotic fluid in womb?
    the doctor told her recently..is there anything she can do?? is there any treatment??

    im really scared for her and her baby.

    1. Christina

      The amniotic fluid that surrounds your baby plays an important role in your baby’s growth and development. This clear-colored liquid protects the baby and provides it with fluids. Your baby breathes this fluid into its lungs and swallows it. This helps your baby’s lungs and digestive system grow strong. Your amniotic fluid also allows the baby to move around, which helps it to develop its muscles and bones.

      The amniotic sac that contains your baby begins to form about 12 days after conception. Amniotic fluid begins to form at that time, too. In the early weeks of pregnancy, amniotic fluid is mainly made up of water supplied by the mother. After about 12 weeks, your baby’s urine makes up most of the fluid.

      The amount of amniotic fluid increases until about 28-32 weeks of pregnancy. At that time you have about 1 quart of fluid. After that time, the level stays about the same until about 37-40 weeks, when your baby is considered full-term. After that, the level begins to decrease.

      What You Need to Know About Oligohydramnios
      Oligohydramnios (too little amniotic fluid) occurs in about 8 out of 100 of pregnancies. It is most common in the last trimester of pregnancy, but it can develop at any time in the pregnancy. About 1 out of 8 women whose pregnancies last 2 weeks past the due date develops oligohydramnios. This happens as amniotic fluid levels naturally decline.

      Oligohydramnios is diagnosed with ultrasound. The causes of this condition are not completely understood. In fact, most pregnant women who develop oligohydramnios have no known cause.

      The most important causes of oligohydramnios early in pregnancy are:
      • Certain birth defects in the baby
      • Ruptured membranes (breaks or tears in the sac that holds the amniotic fluid)

      Birth defects involving the kidneys and urinary tract are the most likely causes of this problem. That’s because babies with these birth defects produce less urine, which makes up most of the amniotic fluid. Some maternal health problems have also been linked with oligohydramnios. These problems include high blood pressure, diabetes, an autoimmune condition called system lupus erythematosus (SLE),and placental problems.

      Oligohydramnios may affect you, your baby, and your labor and delivery in different ways. The effects depend on the cause, when the problem occurs, and how little fluid there is.
      • In the first half of pregnancy, too little amniotic fluid may result in birth defects of the lungs and limbs. During this period, oligohydramnios increases the risk of miscarriage, preterm birth and stillbirth.

      • When oligohydramnios occurs in the second half of pregnancy, it is linked to poor fetal growth.

      • Near delivery, oligohydramnios can increase the risk of complications during labor and delivery.

      Recent studies suggest that women with otherwise normal pregnancies who develop oligohydramnios probably need no treatment. Their babies are likely to be born healthy. Even so, your provider may want to watch you closely. When treatment is needed, the amniotic fluid may need to be replaced with an artificial substitute once the woman is in labor.

      What You Can Do
      The best thing you can do is to go to all your prenatal care appointments. Your health care provider can monitor the size of your belly and how much amniotic fluid is in your womb. If you have a problem, your provider can take steps to help prevent complications in you and your baby.

    1. Linda R

      Women with lupus can have successful pregnancies. But lupus pregnancies are considered high risk. Many are premature. The rheumatologist and obstetrician must work closely together, and the lupus patient must be rigorous about her treatment regimen.

      Problems occur if the woman has any of the lupus clotting factors like antiphospholipid antibody syndrome, anticardiolipin or lupus anticoagulant. These can cause blood clots which interrupt the flow of blood through the placenta to the baby. Some of the medications are dangerous for the developing fetus as well.

      A small percentage of babies born to lupus mothers will have congenital heart block.

      More than half the women in my lupus support group have had successful pregnancies with healthy children.

  2. bansallshetall

    Iam beautiful looking 31 years old woman.after my preganancy i got butterfly pigmentation.?
    i want to know does glycolic peel help me?is there any other treatment which can help me to have flawless skin permanentlly.

    1. scaryclairy

      Butterfly pigmentation???
      My guess in u r meaning a rash acros the bridge of ur nose onto ur cheeks that looks like a butterfly. And you got this after ur pregnancy.
      So that really sound like it might be a sign of an autoimmune condition know as systemic lupus erythomatosus (SLE, or lupus). I would go and get it shecked out by ur doctor. If u can get it treated then the rash will have the best chance of disapearing.

    1. Anonymous

      ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.

      Cardiovascular: Intracranial hypertension, pericarditis

      Dermatologic: Angioneurotic edema, exfoliative dermatitis (rare), photosensitivity, rash, skin hyperpigmentation, urticaria

      Endocrine & metabolic: Brown/black discoloration of thyroid gland (no dysfunction reported), hypoglycemia

      Gastrointestinal: Anorexia, diarrhea, dysphagia, enterocolitis, esophagitis (rare), esophageal ulcerations (rare), glossitis, inflammatory lesions in anogenital region, nausea, oral (mucosal) pigmentation, pseudomembranous colitis, tooth discoloration (children), vomiting

      Hematologic: Eosinophilia, hemolytic anemia, neutropenia, thrombocytopenia

      Hepatic: Hepatotoxicity (rare)

      Renal: BUN increased (dose related)

      Miscellaneous: Anaphylactoid purpura, anaphylaxis, bulging fontanels (infants), serum sickness, SLE exacerbation

      Note: Adverse effects in clinical trials with Periostat® occurring at a frequency more than 1% greater than placebo included nausea, dyspepsia, joint pain, diarrhea, menstrual cramp, and pain.

      CONTRAINDICATIONS — Hypersensitivity to doxycycline, tetracycline or any component of the formulation; children ≤ 8 years of age, except in treatment of anthrax (including inhalational anthrax postexposure prophylaxis)

      WARNINGS / PRECAUTIONS
      Concerns related to adverse effects: Autoimmune syndromes: Have been reported. Hepatotoxicity: Rarely occurs; if symptomatic, conduct LFT and discontinue drug. Increased BUN: May be associated with increases in BUN secondary to antianabolic effects; use caution in patients with renal impairment. Photosensitivity: May cause photosensitivity; discontinue if skin erythema occurs. Use skin protection and avoid prolonged exposure to sunlight; do not use tanning equipment. Pseudotumor cerebri: Has been (rarely) reported with tetracycline use; usually resolves with discontinuation. Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

      Special populations: Pediatrics: May cause tissue hyperpigmentation, enamel hypoplasia, or permanent tooth discoloration; use of tetracyclines should be avoided during tooth development (children ≤ 8 years of age) unless other drugs are not likely to be effective or are contraindicated. However, recommended in treatment of anthrax exposure. Pregnancy: Do not use during pregnancy. In addition to affecting tooth development, tetracycline use has been associated with retardation of skeletal development and reduced bone growth.

      Dosage form specific issues: Oracea™ : Should not be used for the treatment or prophylaxis of bacterial infections, since the lower dose of drug per capsule may be subefficacious and promote resistance. Periostat®: Effectiveness has not been established in patients with coexistent oral candidiasis; use with caution in patients with a history or predisposition to oral candidiasis. Syrup: Contains sodium metabisulfite.

  3. ♥ Her ♥

    How is it that your amniotic fluid becomes “low”?
    This may seem like a really dumb question, but how can amniotic fluid just become low? My friend is 33 weeks and went in today and they did an ultrasound for some reason or another and said her fluid was too low, so they might need to induce her within the next week or two if things dont improve. Before this, her fluids were fine, and she was not leaking (they confirmed with tests).. SO how did they just lower like that? I dont understand how it could happen.

    1. Willow O

      What You Need to Know About Oligohydramnios
      Oligohydramnios (too little amniotic fluid) occurs in about 8 out of 100 of pregnancies. It is most common in the last trimester of pregnancy, but it can develop at any time in the pregnancy. About 1 out of 8 women whose pregnancies last 2 weeks past the due date develops oligohydramnios. This happens as amniotic fluid levels naturally decline.

      Oligohydramnios is diagnosed with ultrasound. The causes of this condition are not completely understood. In fact, most pregnant women who develop oligohydramnios have no known cause.

      The most important causes of oligohydramnios early in pregnancy are:
      • Certain birth defects in the baby
      • Ruptured membranes (breaks or tears in the sac that holds the amniotic fluid)

      Birth defects involving the kidneys and urinary tract are the most likely causes of this problem. That’s because babies with these birth defects produce less urine, which makes up most of the amniotic fluid. Some maternal health problems have also been linked with oligohydramnios. These problems include high blood pressure, diabetes, an autoimmune condition called system lupus erythematosus (SLE),and placental problems.

      Oligohydramnios may affect you, your baby, and your labor and delivery in different ways. The effects depend on the cause, when the problem occurs, and how little fluid there is.
      • In the first half of pregnancy, too little amniotic fluid may result in birth defects of the lungs and limbs. During this period, oligohydramnios increases the risk of miscarriage, preterm birth and stillbirth.

      • When oligohydramnios occurs in the second half of pregnancy, it is linked to poor fetal growth.

      • Near delivery, oligohydramnios can increase the risk of complications during labor and delivery.

      Recent studies suggest that women with otherwise normal pregnancies who develop oligohydramnios probably need no treatment. Their babies are likely to be born healthy. Even so, your provider may want to watch you closely. When treatment is needed, the amniotic fluid may need to be replaced with an artificial substitute once the woman is in labor.

  4. VK Duzell

    Can you confirm if my answers are correct for Human Anatomy and Physiology (bones, muscles, etc)?
    All my answers are marked ***
    By the way am I allowed to do this confirm my answers thingy??
    THANK YOU SO MUCH FOR EVERYONE WHO HELPS!!

    1. Superficial fascia of muscle:

    a. is found between the skeletal muscles and the bones
    b. provides a route for lymphatic and blood vessels as well as nerves to enter muscles***
    c. stores most of the body’s proteins
    d. is composed primarily of dense connective tissue
    e. promotes heat loss

    2. Exercise in arthritis:

    a. improves circulation and increases phagocyte activity for repair
    b. improves well being
    c. damages the joints so should be minimised
    d. promotes the acite inflammatory response (AIR) and hence increases pain
    e. lubricates joints and strengthens supporting muscles***

    3. Spongy bone:

    a. stores yellow bone marrow***
    b. stores red bone marrow
    c. is located primarily in long bones
    d. makes bones heavier than if they had only osteons
    e. is arranged in osteons

    4. Osteogenic cells:

    a. are unspecialized cells
    b. line the haversian canals
    c. are osteoclasts that have lost their function
    d. are osteoblasts turning into osteocytes
    e. produce the collagen fibres***

    5. The calcaneal (Achilles) tendon is formed by the fusion of the tendons of the:

    a. rectus femoris, vastus medialis, vastus lateralis
    b. erector spinae, splenius group, scalenes
    c. gluteus maximus, gluteus medius, gluteus minimus
    d. gastrocnemius, soleus, plantaris***

    6. Elderly women or men with a normal bone mass measured by DXA may also be diagnosed with osteoporosis if:

    a. impaired breathing
    b. a low-trauma fracture occurs***
    c. long term steroid use
    d. bone mass is confirmed by x-ray
    e. a family history of fracture

    7. Movement at a joint that is similar to the opening and closing of a door is what kind of joint?

    a. Plantar
    b. Pivot
    c. Ball and socket
    d. Hinge***
    e. Saddle

    8. A patient with rheumatoid arthritis (RA) begins therapy with etenercept (a disease-modifying antirheumatic drug-DMARD). The patient should be instructed to avoid:

    a. alcohol
    b. live vaccines***
    c. passive motion exercises
    d. grapefruit
    e. high fat food

    9. When initiating therapy with the drug minocycline, your patient with rheumatoid arthritis should be informed that the most common side effects are:

    a. skin rash and dizziness
    b. nausea and vomiting***
    c. abdominal pain and diarrhoea
    d. headache and mouth ulcers

    10. During a maximal skeletal muscle contraction:

    a. the connective tissue coverings are pulled taut and pull on bone
    b. body temperature decreases
    c. muscle cells shorten along the length and width of the cell***
    d. skeletal muscle pass the action potential on to other cells
    e. causes the H zone to widen

    11. The cells expected to be most active in replacing bone matrix lost due to an injury would be:

    a. osteoclasts
    b. macrophages
    c. fibrocytes
    d. osteocytes
    e. osteoblasts***

    12. A neuromuscular junction (NMJ):

    a. includes the synaptic end bulbs of the muscle fibre
    b. includes the motor endplates of the motor neurone
    c. uses adrenaline as a neurotransmitter
    d. uses Na+ as a neurotransmitter
    e. is the synapse of a motor neurone with a muscle fibre***

    13. A muscle fibre is a muscle ______ :

    a. cell***
    b. contractile unit
    c. sarcomere (a fibr is a repitition of sarcomeres)
    d. protein

    14. Myasthenia gravis is mediated by:

    a. thymectomy*** (results in remission of myasthenia gravis)
    b. ptosis
    c. immunoglobulin
    d. plasmaphoresis
    e. acetyl cholinesterase (AChE)

    15. The breakdown of bone matrix:

    a. keeps up with osteoblast activity***
    b. is conducted by osteoblasts
    c. requires the deposition of mineral salts by osteocytes
    d. removes minerals and proteins from the blood

    16. The presence of urate crystals in joints results in:

    a. ankylosing spondylitis
    b. osteoarthritis
    c. rheumatoid arthritis
    d. gouty arthritis***
    e. infection arthritis

    17. Which type of fracture results in broken bones sticking out through the skin?

    a. Compression
    b. Compound***
    c. Comminuted
    d. Greenstick

    18. Primary osteoporosis is associated with:

    a. post menopausal bone loss***
    b. premature ossification
    c. endocrine disorders
    d. long term steroid use
    e. malnutrition

    19. The aetiology of osteoporosis includes:

    a. loss of bone density***
    b. age or endocrine disorders
    c. increasing bone porosity
    d. susceptibility to fracture
    e. spontaneous mutation

    20. Compared to intramembranous ossification, endochondral ossification:

    a. allows both interstitial and appositional growth***
    b. is less complex
    c. requires fewer types of cells
    d. requires the presence of blood vessels in order to form chondrocytes
    e. results in mature bone with a very different histology

    21. Pannus in rheumatoid arthritis (RA) directly causes:

    a. increasing ankylosis
    b. general malaise
    c. red, warm and swollen joints***
    d. extra articular changes
    e. Rheumat
    What’s an NCLEX book??

  5. Tara L

    microgynon 30? help please?
    around 2 months ago i stopped taking the pill (microgynon 30) i had been on it a while… and was having lots of side effects so stopped taking it
    anyway…. i was just wondering what are some of the things that happen once u stop taking it?
    past few days ive had back ache, very slight cramping down below, few headaches and today i didnt wake up until 1.30pm!! which is so not like me.. im usually awake by 11am at the latest!! i came of my period around a week ago…
    so what are some of the things that can happen once u stop taking it?
    my periods have been regular since i stopped taking it.
    thanks 🙂

    1. Bailey's mom♥

      Stop taking this medicine and inform your doctor immediately if you get any of the following symptoms while taking the medicine: stabbing pains and/or unusual swelling in one leg, pain on breathing or coughing, coughing up blood, sudden breathlessness, sudden severe chest pain, migraine or severe headaches, sudden disturbance in vision, hearing or speech, sudden weakness or numbness on one side of the body, fainting, collapse, epileptic seizure, significant rise in blood pressure, itching of the whole body, yellowing of the skin or whites of the eyes (jaundice), severe stomach pain, severe depression, or if you think you could be pregnant.
      Use with caution in
      Women aged over 35 years.
      Women whose parent, brother or sister had a stroke caused by a blood clot or a heart attack before the age of 45.
      Women with a parent, brother or sister who has had a blood clot in a vein (venous thromboembolism), eg in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism) before the age of 45.
      Obesity.
      Smokers.
      Diabetes mellitus.
      High blood pressure (hypertension).
      Women who use a wheelchair.
      Varicose veins.
      Hereditary blood disorder called sickle cell disease.
      History of severe depression.
      History of migraines.
      Inflammatory bowel disease, eg Crohn’s disease or ulcerative colitis.
      History of liver disease.
      Decreased kidney function.
      Heart failure.
      History of gallstones.
      Close family history of breast cancer (eg mother or sister has had the disease).
      History of irregular brown patches appearing on the skin, usually of the face, during pregnancy or previous use of a contraceptive pill (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking this contraceptive.
      Not to be used in
      Known or suspected pregnancy.
      Breastfeeding (until weaning or for six months after birth).
      Women who have ever had a blood clot in a vein (venous thromboembolism), eg in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
      Blood disorders that increase the risk of blood clots in the veins, eg antiphospholipid syndrome or factor V Leiden.
      Long-term condition called systemic lupus erythematosus (SLE).
      Excess of urea in the blood causing damaged red blood cells (haemolytic uraemic syndrome).
      Women with two or more other risk factors for getting a blood clot in a vein, eg family history of deep vein thrombosis or pulmonary embolism before the age of 45 (parent, brother or sister), obesity, varicose veins, long-term immobility.
      Women who have ever had a blood clot in an artery, eg a stroke or mini-stroke caused by a blood clot, or a heart attack.
      Angina.
      Heart valve disease.
      Irregular heartbeat caused by very rapid contraction of the top two chambers of the heart (atrial fibrillation).
      Moderate to severe high blood pressure (hypertension).
      High cholesterol levels.
      Severe diabetes with complications, eg affecting the eyes, kidneys or nerves.
      Women who smoke more than 40 cigarettes per day.
      Women over 50 years of age.
      Women with two or more other risk factors for getting a blood clot in an artery, eg family history of heart attack or stroke before the age of 45 (parent, brother or sister), diabetes, high blood pressure, smoking, age over 35 years, obesity, migraines.
      Women who get migraines with aura, severe migraines regularly lasting over 72 hours despite treatment, or migraines that are treated with ergot derivatives.
      History of breast cancer.
      Cancer involving the genital tract.
      Vaginal bleeding of unknown cause.
      Severe liver disease, eg liver cancer, hepatitis.
      History of liver disease when liver function has not returned to normal.
      Disorders of bile excretion that cause jaundice (eg Dubin-Johnson or Rotor syndrome).
      Gallstones (cholelithiasis).
      History of jaundice, severe itching, hearing disorder called otosclerosis, or rash called pemphigoid gestationis during a previous pregnancy, or previous use of sex hormones.
      Hereditary blood disorders known as porphyrias.
      This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

      Pregnancy and breastfeeding
      Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

      This medicine is used to prevent pregnancy and should not be taken during pregnancy. If you think you could be pregnant while taking this pill you should stop taking it and consult your doctor immediately. However, if the pill fails and you do become pregnant while taking it, there is no evidence to suggest t

  6. debberu

    Does anyone have Hughes Syndrome?? My husband does and I wanted to compare notes.?
    At 36 years old, he had a stroke and consequently was diagnosed w/ anticardiolipid antibody syndrome (Hughes Syndrome)

    He gets his blood checked every month now.

    1. a2222nath

      Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with typical laboratory abnormalities.
      An alteration of the homeostatic regulation of blood coagulation occurs.
      The series of events that leads to hypercoagulability and recurrent thrombosis can affect the extremities and virtually any organ system, including the following:

      Peripheral venous system (deep venous thrombosis [DVT])

      Central nervous system (cerebrovascular accident [CVA], sinus thrombosis)

      Hematologic (thrombocytopenia, hemolytic anemia)

      Obstetric (pregnancy loss, eclampsia)

      Pulmonary (pulmonary embolism, pulmonary hypertension)

      Dermatologic (livedo reticularis, purpura, infarcts/ulceration)

      Cardiac (Libman-Sacks valvulopathy, myocardial infarction)

      Ocular (amaurosis, retinal thrombosis)

      Adrenal (infarction/hemorrhage)

      Musculoskeletal (avascular necrosis of bone)
      A female predominance is documented.
      APS occurs more commonly in young-to-middle–aged adults.
      : Patients with APS may be evaluated in an outpatient setting. Inpatient evaluation is required if the patient presents with a significant clinical event. Patients with CAPS require intense observation and treatment, often in an intensive care unit setting.

      In general, treatment regimens for APS must be individualized according to the patient’s current clinical status and history of prior thrombotic events.

      Prophylactic therapy

      Eliminate other risk factors, such as oral contraceptives, smoking, hypertension, or hyperlipidemia.

      Low-dose aspirin is used widely in this setting; however, the effectiveness of low-dose aspirin as primary prevention for APS remains unproven. Clopidogrel has anecdotally been reported to be helpful in persons with APS and may be useful in patients allergic to aspirin.

      Consider the use hydroxychloroquine in patients with SLE (may have intrinsic antithrombotic properties).
      Thrombosis
      Perform full anticoagulation with intravenous or subcutaneous heparin followed by warfarin therapy.

      Based on the most recent evidence, a reasonable target for the international normalized ratio (INR) is 2.6-3 for a minimum of 6 months for a first thrombosis. Patients with recurrent thrombotic events while well maintained on the above regimen may require an INR of 3-4 and generally receive anticoagulation therapy for life. For severe or refractory cases, a combination of warfarin and aspirin may be used.
      Obstetric considerations
      Subcutaneous heparin (unfractionated or low–molecular-weight heparin [LMWH]) and low-dose aspirin are used. Therapy is held at the time of delivery; it is restarted after delivery and should be continued for as long as 6 weeks postpartum. Most authors avoid warfarin (Coumadin) because it is category X in pregnancy.

      If the patient also has a history of thrombosis, then long-term anticoagulation is needed.

      Corticosteroids have not been proven effective for persons with primary APS, and they have been shown to increase maternal morbidity and fetal prematurity.

      Heparin and warfarin may be used while breastfeeding.
      Catastrophic APS

      These patients generally are very ill, often with active SLE.

      Treatment with intensive anticoagulation and plasmapheresis appears beneficial, but no controlled trials have been performed.

      Additionally, corticosteroids, cyclophosphamide, and intravenous immunoglobulin may be used.
      Surgical Care: Recurrent DVT may necessitate placement of an inferior vena cava filter.

      Consultations:

      Rheumatologist
      Hematologist
      Neurologist, cardiologist, pulmonologist, hepatologist, ophthalmologist (depending on clinical presentation)
      Obstetrician with experience in high-risk pregnancies
      Diet:

      If warfarin therapy is instituted, instruct the patient to avoid excessive consumption of foods containing vitamin K.
      Activity:

      No specific limitations on activity are necessary.
      Individualize the activity according to the clinical setting.
      Instruct the patient to avoid sports with excessive contact if taking warfarin.
      Limit activity in patients with acute DVT.
      Instruct the patient to avoid prolonged immobilization.
      Instruct the patient to avoid smoking.
      Inform the patient to avoid oral contraceptives or estrogen replacement therapy.
      Ensure that the patient avoids any prolonged immobilization.
      With appropriate medication and lifestyle modifications, most individuals with primary APS lead normal, healthy lives. However, subsets of patients continue to have thrombotic events despite aggressive therapies. For these patients, the disease course can be devastating, often leading to significant morbidity or early mortality.
      Patients with secondary APS carry a similar prognosis; however, morbidity and mortality may also be influenced by these patients’ underlying autoimmune or rheumatic condition. In patients with SLE and APS, aPL antibodies have been associated with neuropsychiatric disease and have been recognized as a major predictor of irreversible organ damage.
      Women with aPL antibodies who experience recurrent miscarriages may have favorable prognoses in subsequent pregnancies if treated with aspirin and heparin.
      Patient Education:

      Stress the importance for early recognition of a possible clinical event.
      Educate the patient about anticoagulation therapy.
      To increase comfort and lower the risk of the clot embolizing and moving to the lung, take the following measures:

      Keep the affected limb elevated.

      Avoid prolonged sitting or bed rest.

      Relieve pain by applying warm, moist heat to the area.

      The key to prevention is to reverse any risk factors, as follows:

      If you are obese, try to lose weight.

      Avoid periods of prolonged immobility.

      Keep your legs elevated while sitting down or in bed.

      Avoid high-dose estrogen pills, unless they are deemed necessary by your health care provider.
      If you had surgery recently, preventive treatment may be prescribed for you to avoid formation of a clot.

      You may be instructed to get out of bed several times a day during the recovery period.

      Sequential compression devices (SCDs) may be placed on your legs. Their squeezing action has been shown to reduce the probability of clot formation. You also may be given elastic stockings to wear.

      Low molecular weight heparin or low-dose warfarin may be prescribed to prevent clot formation.

  7. Lucy

    Um purple nail beds….?
    I always have purple nail beds , even if my hands arent cold …..what does this mean? btw im 120 pound maybe alittle under 5’3 very pale and have black and purple rings almost always around my eyes…my health is pretty normal but i am tired alot but i am always working and going to school but when i have off no matter what for the life of me i do not want to do anything…someone help? maybe a blood problem? does anyone know anything that can help my body be stronger? thanks 🙂

    1. matador 89

      Lucy,
      You state nail beds in the plural. This must indicate that all your nail beds are purple. The nail bed is the surface beneath the nail plate, which is the part that you see and which you either cut (or bite) at one end and has the lunula (white half moon) and then the cuticle at the other! The description that you give indicates possible splinter haemorrhage, which may be caused by subacute bacterial endocarditis, SLE, rheumatoid arthritis, antiphospholipid syndrome, peptic ulcer disease, malignancies, oral contraceptive use, pregnancy, psoriasis, trauma. This does not mean that you may be suffering from one of these, but is an indication of possible causes. There are others, which I shall not discuss at this time. You would be advised to see your doctor and if, following an examination, it is considered that you should have a blood test, that would either exclude or confirm any possible causes like thyroid problems etc, that would show in the blood.

      ALL ANSWERS SHOULD BE THOROUGHLY RESEARCHED, IN ANY FORUM AND ESPECIALLY IN THIS ONE. – MANY ANSWERS ARE FLAWED.

      It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms.

      The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

      Hope this helps
      matador 89

  8. Anonymous

    Im scared to take my new B/C pill – MERCILON?!?
    I have a new pack of pills, Mercilon, which I want to try but im scared of side effects. Im at a gig next Tuesday and I have a feeling that I might be on but want to prevent this by starting my new pill but at the same time I dont want to feel horrible. What are your experiences on Mercilon?

    1. Kim

      Use with caution in
      Women aged over 35 years.
      Women whose parent, brother or sister had a stroke caused by a blood clot or a heart attack before the age of 45.
      Obesity.
      Smokers.
      Diabetes mellitus.
      High blood pressure (hypertension).
      Varicose veins.
      Women who use a wheelchair.
      Anaemia caused by a hereditary blood disorder where abnormal haemoglobin is produced (sickle cell anaemia).
      History of severe depression.
      History of migraines.
      Inflammatory bowel disease, eg Crohn’s disease or ulcerative colitis.
      History of liver disease.
      Decreased kidney function.
      Heart failure.
      History of gallstones.
      Close family history of breast cancer (eg mother or sister has had the disease).
      History of irregular brown patches appearing on the skin, usually of the face, during pregnancy or previous use of a contraceptive pill (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking this contraceptive.
      Not to be used in
      Known or suspected pregnancy.
      Breastfeeding (until weaning or for six months after birth).
      Personal or family history of a blood clot in a vein (venous thromboembolism), eg in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
      Blood disorders that increase the risk of blood clots in the veins, eg antiphospholipid syndrome or factor V Leiden.
      Long-term condition called systemic lupus erythematosus (SLE).
      Excess of urea in the blood causing damaged red blood cells (haemolytic uraemic syndrome).
      Women with two or more other risk factors for getting a blood clot in a vein, eg obesity, varicose veins, long-term immobility.
      Women who have ever had a blood clot in an artery, eg a stroke or mini-stroke caused by a blood clot, or a heart attack.
      Angina.
      Heart valve disease.
      Irregular heartbeat caused by very rapid contraction of the top two chambers of the heart (atrial fibrillation).
      Moderate to severe high blood pressure (hypertension).
      High cholesterol levels.
      Severe diabetes with complications, eg affecting the eyes, kidneys or nerves.
      Women who smoke more than 40 cigarettes per day.
      Women over 50 years of age.
      Women with two or more other risk factors for getting a blood clot in an artery, eg family history of heart attack or stroke before the age of 45 (parent, brother or sister), diabetes, high blood pressure, smoking, age over 35 years, obesity, migraines.
      Women who get migraines with aura, severe migraines regularly lasting over 72 hours despite treatment, or migraines that are treated with ergot derivatives.
      History of breast cancer.
      Cancer involving the genital tract.
      Vaginal bleeding of unknown cause.
      Severe liver disease, eg liver cancer, hepatitis.
      History of liver disease when liver function has not returned to normal.
      Disorders of bile excretion that cause jaundice (eg Dubin-Johnson or Rotor syndrome).
      Gallstones (cholelithiasis).
      History of jaundice, severe itching, hearing disorder called otosclerosis, or rash called pemphigoid gestationis during a previous pregnancy, or previous use of sex hormones.
      Hereditary blood disorders known as porphyrias

      I’m not sure if you are interested in alternative BC methods, have a look at the site below. I used this method for 20years and it never failed me.

    1. tt

      Do not take more of this medication than is recommended. An overdose of ibuprofen can cause damage to your stomach or intestines. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of this medication needed to get relief from your pain, swelling, or fever. Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form). Do not drink alcohol while taking this medication. Alcohol can increase your risk of stomach bleeding caused by ibuprofen.
      Before taking ibuprofen
      Taking an NSAID such as ibuprofen can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

      NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

      Do not use this medication if you are allergic to ibuprofen, aspirin or other NSAIDs.
      Before taking this medication, tell your doctor if you are allergic to any drugs, or if you have:

      a history of heart attack, stroke, or blood clot;

      heart disease, congestive heart failure, high blood pressure;

      a history of stomach ulcers or bleeding;

      asthma;

      polyps in your nose; or

      liver or kidney disease,
      systemic lupus erythematosus (SLE);

      a bleeding or blood clotting disorder; or

      if you smoke.

      If you have any of these conditions, you may need a dose adjustment or special tests to safely take ibuprofen.

      FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby during early pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. However, taking ibuprofen during the last 3 months of pregnancy may result in birth defects. Do not take this medication during pregnancy unless your doctor has told you to. It is not known whether ibuprofen passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child without the advice of a doctor.

  9. Aubrey Villar

    what treatment for vdrl reactive?
    help me for this.. i really want to know what treatment for this.. i am vdrl reactive..
    i will add details on my problem about vdrl.,. i dont know how long i have this kind of desease but i think it is a yr i have it,, i try to test for vdrl 3 times last yr it is positive and now it is positive,.i didnt treat this because my family dont know about this..i know i get it to my bf before because i see the symptoms on him if there is a syphillis.. and i was scared because we had one daughter,. i didnt know if i was pregnant i have already syphillis.. it so hard to find here a doctor that treat this kind of desease,.

    1. norton g

      Aubrey – return shortly to the physician who ordered your VDRL test to continue with evaluating your test result. Venereal Disease Research Laboratory (VDRL) Test is a slide test employed in the diagnosis of syphilis. It is NOT a specific test. There are many chances of false positive results. False positivity (other than technical) may be due to physiological of pathological conditions. These are called biological false positives (BFP). If they remain positive for less than 6 months it is considered acute and if they remain positive for longer than 6 months it is called chronic BFP. The physiological reasons for BFP include pregnancy, menstruation,
      repeated blood loss, vaccination, severe trauma, etc., while the reasons for pathological BFP include malaria, infectious mononucleosis, hepatitis, relapsing fever, tropical eosinophilia, lepromatous leprosy, SLE, rheumatoid arthritis, etc.
      A reactive VDRL test does not necessarily imply that the person is syphilitic. The diagnosis must be made in conjunction with clinical findings. Any reactive VDRL test must be confirmed with a specific or treponemal test such as TPHA, FTA-ABS test.
      I hope you will now sleep easier and better. Call your doctor for follow-up test evaluation.

    1. Reborn_Wingz

      Antiphospholipid syndrome (APS or APLS) or antiphospholipid antibody syndrome is a disorder of coagulation, which causes blood clots (thrombosis) in both arteries and veins, as well as pregnancy-related complications such as miscarriage, preterm delivery, or severe preeclampsia. The syndrome occurs due to the autoimmune production of antibodies against phospholipid (aPL), a cell membrane substance. In particular, the disease is characterised by antibodies against cardiolipin (anti-cardiolipin antibodies) and β2 glycoprotein I.

      The term “primary antiphospholipid syndrome” is used when APS occurs in the absence of any other related disease. APS is commonly seen in conjunction with other autoimmune diseases; the term “secondary antiphospholipid syndrome” is used when APS coexists with other diseases such as systemic lupus erythematosus (SLE). In rare cases, APS leads to rapid organ failure due to generalised thrombosis and a high risk of death; this is termed “catastrophic antiphospholipid syndrome”.

      Often, this disease is treated by giving aspirin to inhibit platelet activation, and/or Warfarin as an anticoagulant. The goal of the prophylactic treatment is to maintain the patient’s INR between 3.0 – 4.0. It is not usually done in patients who have not had any thrombotic symptoms. During pregnancy, low molecular weight heparin and low-dose aspirin are used instead of Warfarin because of Warfarin’s teratogenicity. Women with recurrent miscarriage are often advised to take aspirin and to start low molecular weight heparin treatment after missing a menstrual cycle.

  10. Renate

    Low Amniotic Fluid….?
    I am 28 weeks pregnant and my dr mentioned that my amniotic fluid is a bit low, he never mentioned anything about concerns, are there any concerns involved in having low amniotic fluid? I do not have lupus, blood pressure or gestational diabetes. I will check with him again when I go in 2 weeks time, but in the meantime anyone else’s views as to what concerns are involved.

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