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Infections, Inflammation, or Hypertension in the Lungs
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Preventive Measures. Immunizations with inactive viruses and preventive antibiotics should be considered for patients with SLE at high risk for infection.
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Treating Infections. Lung infections need to be treated aggressively with antibiotics. (Note: Antibiotic drugs such as penicillin or the sulfa drugs may cause sensitivity rashes that can be confused with SLE rash.)
Treating Lung Inflammation. While inflammation of the lung (pneumonitis) resembles pneumonia, it is not an infection but is a result of the autoimmune process. This condition needs to be treated with corticosteroids or immunosuppressants, but only if the doctor is sure infection is not present.
Treating Pulmonary Hypertension. Pulmonary hypertension is very serious. Drugs known as prostacylins, which include epoprostenol, iloprost, and treprostinil, are standard drugs. Bosentan (Tracleer) is the first oral drug approved for pulmonary hypertension. An inhaled iloprost formulation (Ventavis) was approved in 2004. Sildenafil (Viagara) is also be used for this condition. Lung transplantation may be required.
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Bleeding and Clotting Disorders
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Antiphospholipid Syndrome and Clotting Disorders. Hydroxychloroquine or aspirin may help prevent blood clots in women with antiphospholipid syndrome (APS). (Aspirin does not appear to be protective in men with who carry the autoantibodies responsible for APS.) In patients who have experienced blood clots, treatment with the anticoagulant warfarin (Coumadin) is advisable. This blood-thinning drug may be needed life long. Scientists are investigating other treatment options including autologous stem cell transplantation. This procedure involves removing stem cells from a patient’s blood or bone marrow and then introducing them back into the patient. The procedure has shown promise in studies for treating lupus-associated APS, but it is still experimental.
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