Patient: Description (onset, main symptoms, hospital visited, etc.): Patient female, 43 years old, diagnosed with SLE in March 08, felt shortness of breath when climbing stairs and walking in the last six months, ultrasound in July: right atrial internal diameter significantly enlarged, pulmonary hypertension (80) with tricuspid valve incompetence. Other indicators: 3-hour urine erythrocytes 440,000, leukocytes 440,000, urine protein: weakly positive, leukocyte lipase: 75, partial pressure of carbon dioxide 29, partial pressure of oxygen 82, immunoglobulin IGM:0.34, C3:0.45, C4:0.11, leukocytes 4.93, hemoglobin 160, platelets 147, N:75.9%, erythrocyte sedimentation rate: 2, ANA:1 :320 (granular), weakly positive anti-SM, positive anti-SSA, anti-DS-DNA 6.62. ECG: sinus rhythm, pre-excitation syndrome. Pre-hypertension medication: prednisone 15mg daily, hydroxychloroquine 0.2g. Post-hypertension medication: prednisone 40mg daily, hydroxychloroquine 0.2g, cardiac painkiller 0.1*3, Viagra 25mg*2. Cyclophosphamide 0.6 (every two weeks) has been used three times (once 0.4, twice 0.6) Post-hypertension status: edema was severe after taking cardiac painkiller, now stop taking it, only Viagra 25mg I have not rechecked my heart ultrasound yet. The diagnosis of SLE was mainly due to leukopenia (1.2 at the beginning), which increased after hormones, and urine tests were always good and bad. In two years, when prednisone was reduced to 2.5 grains, the white blood cells were reduced to more than 3,000, and 3 grains from the second half of 2009 to July 10, the diagnosis of high-pressure increase was confirmed. 1.Can I see you and make an appointment if I need to be hospitalized? 2.Can you give me some advice on my current treatment plan? 3.Do I need to wait in line at midnight for your outpatient registration? Wang Qian: Your diagnosis is very clear, the root cause is lupus erythematosus, and the main problem is pulmonary hypertension. The treatment of pulmonary hypertension caused by lupus erythematosus is different from primary pulmonary hypertension. Suggestions: 1) Fenugreek is weaker and pulmonary hypertension is an important organ involvement, and switching to stronger immunosuppressants should be considered. 2) Sildenafil is increased to 25mg. Patient: Thank you very much for your reply in your busy schedule and for delaying your rest. Currently I am on cyclophosphamide 0.6 every three weeks and sildenafil 25mg three times a day, what immune agents can you recommend? I would like to come to Beijing after the National Day, and I wonder if you can add a number for me. I would also like to know the process of adding a number, whether I should register first, or register after I have an extra number. Thank you very much! Wang Qian: I think the current plan is fine, and we need to see the patient and the test results before deciding whether we need to adjust it, because everyone, especially every lupus patient, has a different condition. I am in clinic every Monday afternoon, so you can come to the office and add your number directly then. If there are any changes, they will be announced in advance on the front page of this website, please note. Patient: Thank you. I will contact you again before I come (I am initially scheduled to see you on October 11), can I make an appointment online to add a number and come directly to your office to add a number. Is it okay if I bring a recent checkup from my local hospital? I usually have monthly blood tests, blood sedimentation, liver function, kidney function, anti-doublet DNA, urine routine, and heart ultrasound. I don’t know how long it will take to get the results if I need other tests in Beijing. Wang Qian: You may need to stay about 1 week longer for the first visit to complete the tests. If the right heart floating catheterization is not performed, it is recommended to stay in the hospital once for a comprehensive evaluation, which is helpful to deepen the understanding of the disease and to grasp the next treatment plan. Due to the work schedule of the department, I am not open for registration at this time, but I will add additional units for patients with pulmonary hypertension, depending on the number of patients in each unit. Therefore, it is recommended that you make an appointment online to ensure that you have enough time for your visit. Click here to make an appointment for an extra number in my clinic Patient: Yes, I’ll make an appointment when I come in. Thank you!