20F Lupus paJR



[2/1, 8:39 AM] saicharankulkarni: Spoke to this patient and her father today, she has no complaints except swelling of face ( ? iatrogenic Cushings ). She was on Oral prednisone 20 - x - 10mg, tappered to 10mg twice daily using since 3 days. They are in a plan to visit our OPD in 2-3 days sir..

[2/1, 8:51 AM] Dr Rakesh Biswas Sir Hod Gm Kam: Did you try to find out more about her possible neurodegenerative disorder that you brought out in the conference?

[2/7, 11:47 PM] saicharankulkarni: Came for review today

Complaints of difficulty in sitting on floor, difficulty in getting up from chair since 1 month, 

O/e 
Facial swelling+
Hump behind the neck +
B/L lower limb Proximal muscle weakness +
Hyperreflexia of all DTR + since 4 months
Abdominal striae + on lateral aspect of abdomen and knee
B/L fine tremors +
Amenorrhea since 4 months ( LMP in october )
Bp - 110/70mmhg
Pr - 78bpm

[2/8, 8:16 AM] Dr Rakesh Biswas Sir Hod Gm Kam: So is her current proximal myopathy due to Cushing's or Polymyositis? 
How would you decide?

[2/27, 9:02 AM] saicharankulkarni: Reviews case through teleconsultation 

C/o facial puffiness decrease ( not completely subsided ),
hair loss present
Difficulty in standing from sitting position decreased.

Decreased wysolone dose from 10mg - X - 5mg to 5mg twice daily. She is on HCQ, AZA
Advised to review general medicine OPD.

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