Patient: Hello! My mother, 64 years old, has been losing weight since the end of 2009, has had colds twice a month since January 2010, has pain in both legs and knees, cannot walk freely, and has been constipated for a few days after taking a bone pill in mid to late March, then had difficulty in passing stool, and then in mid-April she found a Chinese doctor to prescribe medicine and then became having stool 8-10 times a day, and by early May she had lost nearly 20 pounds (from 96 pounds at the end of last year to 80 He was admitted to hospital. Main symptoms: unbearable pain in both legs, especially in the joints, inability to walk, facial swelling, 8-10 times/day of stool, change in stool characteristics After 10 days of inpatient examination, she was diagnosed with systemic lupus erythematosus and chronic inflammation of the rectal mucosa, a small amount of fluid in the pericardium and fluid in the pelvis, and was discharged after 14 days of inpatient treatment. Since her discharge from the hospital, she has been having 2-3 bowel movements per day, and her bowel movements are generally normal (but in the last few days, she has been struggling with her bowel movements). The soles of her feet always feel thick, and when she stands for a long time, the soles of her feet become red and numb, and she feels like she has grown an extra layer of thick skin. The examination results from the time of admission to the latest follow-up are as follows: 1. Is the disease now severe/moderate/light? 2. which type of SLE is it? (I read on the internet that there are lupus nephritis and lupus pneumonia.) 3. Is the blood sedimentation test result related to the duration of medication? My mother was discharged from the hospital with a sedimentation rate of 70. After her discharge, she took prednisone acetate (50mg per day) at around 7:30 p.m. and was seen every 2 weeks. The doctor said to add primaquine or cyclophosphamide and asked for our opinion. He said that primaquine is fast and has few side effects, but it is expensive (about 3,000 for 1 month), while cyclophosphamide is slower and has many side effects, but it is cheaper. Snapdragon is really too expensive for a working class person like us, but we are worried about the side effects of cyclophosphamide on the elderly. I would like to hear your advice from the doctor. 5. The main doctor said that cyclophosphamide is given by suspension, can I take oral cyclophosphamide instead of suspension? Is the effect the same? 6. Do you think it is appropriate to wait for 2 weeks to see the blood sedimentation before deciding whether to increase the medication? 7. My mom washes her hair once a week and I counted over 800 hairs in this wash! Do we need to check anything or pay attention to anything? Sorry for asking more questions, please understand the anxiety and helplessness of being a son or daughter. 1. Judging from your description of your mother’s condition, the elderly person’s condition is still in the active stage and her condition is on the heavy side. 2.Systemic lupus erythematosus is a disease with multi-system damage, which can include damage to the blood system, kidneys, lungs, plasma cavity and nervous system. The disease can occur simultaneously with the above-mentioned multi-system damage, i.e. lupus nephritis and lupus pneumonia as you mentioned can occur in one patient at the same time. Since you only described the specific symptoms but not the laboratory results, I am unable to determine which organ systems are damaged and the degree of damage for the time being. 3.Blood sedimentation is an indicator reflecting the activity of inflammatory disease, and a variety of factors can cause fluctuations in this indicator, which is not obviously related to the time of taking medication. The three laboratory results you described are all higher than the normal range, suggesting that the inflammation is still active and the disease is not well controlled. 4. If economic conditions do not allow, cyclophosphamide can be applied, but the side effects of the drug should indeed be noted when using it. Routine low-dose application of the drug is safer, but should be reviewed regularly. 5.There are indeed oral cyclophosphamide tablets, the effect of which is not significantly different from the effect of intravenous drip, but I do not know whether the drug is available in Guangzhou. 6.The increase or decrease of drugs should not be based on blood sedimentation indicators alone, but need to be considered comprehensively. Including blood routine, liver and kidney function, complement status and antibody status. A combination of the above-mentioned laboratory test results, before the final decision whether to add drugs, plus what drugs. The phenomenon you described is related to the disease your mother is suffering from, and it is a unique phenomenon of hair loss in lupus patients, called lupus hair, which can generally be relieved or reversed after the disease is controlled. I wish your mother well and a speedy recovery!