Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): My daughter, 14 years old, had a fever on December 10, without coughing and headache, etc. She went to the county hospital for routine blood tests and only found a low white blood cell level of 2.61, other indicators were normal, all parts of her body were normal, and there was no spotted rash. Hospital diagnosis of viral infection, and treatment for four days, high fever 37.3-39 degrees does not subside. On the 15th, he was transferred to the First People’s Hospital of Lianyungang City, where he was examined (experience report on December 15) for low white blood cells, platelets and hemoglobin, and was treated with cephalexin and feverfew. On the 16th, he had a puncture and related tests, and was found to have high ferritin and ghrelin (see experience report on the 16th). The fever did not go away. On the 22nd, after the laboratory report came out, the diagnosis of SLE was positive for anti-nuclear antibody and anti-double-stranded DNA antibody, and the fever subsided to normal with the addition of hormone shock. On the 7th of January, after the second hormone shock was completed, the routine blood test showed that the white blood cells were 5.6 and platelets were 167, only the liver function was a little abnormal. The urine and feces, kidney function, heart function and temperature were normal, sleep, diet, spirit and activity were normal. During the fever on the 20th, a slight rash appeared on the face, which disappeared after the use of hormones. Now it is the same as normal child. 1. Whether the above symptoms can confirm the diagnosis of SLE, because my daughter has no symptoms in this area at all. 2. The hospital wants to use cyclophosphamide, but the parents have not agreed for the time being, whether it is available. 3. The cause of elevated ferritin. Rheumatology and Immunology Cai Xiaoyan, Guangzhou First People’s Hospital: It can be diagnosed. Not everyone with lupus erythematosus shows facial erythema or problems with all organs. In addition to hormone therapy, most patients need to add immunosuppressants such as cyclophosphamide, mycophenolate, azathioprine, etc., depending on the condition. Patient: Thank you, Director Cai: Yesterday my daughter went to the hospital for a review and had a routine blood test with the following results: 1. white blood cells: 10.97 2. percentage of neutrophils: 74.6 3. percentage of lymphocytes 15.5 4. percentage of eosinophils 0.5 5. percentage of basophils 0.3 6. percentage of monocytes 9.1 7. absolute value of neutrophils 8.18 8. absolute value of lymphocytes 1.7 9. absolute value of eosinophils 0.06 10. basophils absolute value 0.03 11. monocytes absolute value 1.00 12. hemoglobin 139 13. erythrocytes 4.52 14. erythrocyte distribution width (SD) 54.7 15. erythrocyte distribution width (CV) 16.8 16. mean blood cell volume 90.9 17. mean hemoglobin content 30.8 18. mean hemoglobin concentration 338 19. platelets 223 20. mean platelet volume 9.7 21. platelet distribution width 10.0 22. platelet ratio 0.22 Now take prednisone acetate tablets three times a day, 4 tablets each time, for 20 days, the patient: please take other drugs Thank you Guangzhou First People’s Hospital Rheumatology and Immunology Cai Xiaoyan: Hormones are best taken in one sitting after breakfast. For example: Prednisone acetate tablets three times, 4 tablets each time, instead of 12 tablets in the morning, so that the side effects of hypothalamus-pituitary-adrenal feedback inhibition will be less. After the disease is controlled, the hormone dosage is gradually reduced. In addition, lupus erythematosus cannot be controlled by hormones alone, and immunosuppressive drugs need to be added according to the presence of organ damage.