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Old 05-17-2013, 01:23 PM   #1
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Should I start Plaquenil? Just diagnosed with SLE- have included lab tests

2 weeks ago, I went in to see my doctor for strange skin lesions on my back, face and ear. She referred me to a rheumatologist, and my ANA test came back positive as did my anti-Smith test which the doctor says indicate I have lupus; I am following up with a derm to do a skin biopsy.

Today, my rheumatologist sent me this message:
"This confirms the positive ANA test at a significant, although not extremely high, level. The C3 complement level (a blood protein involved in inflammation) is mildly low, which is typical of systemic lupus erythematosus.
I hope that you have the skin biopsy soon.
Let me know if you are interested in starting Plaquenil."

My question - should I start Plaquenil or wait until my skin biopsy comes back? I am only hesitant about starting medication because of the side effects, and right now my symptoms are pretty mild. Can anyone help shed some light on this? In any case, I have asked my doctor to prescribe Plaquenil.


My other test results are as follows:
CARDIOLIPIN ANTIBODY - negative
LUPUS ANTICOAGULANT - negative
Glucose-6-phosphate dehydrogenase - 11.0 (range >=4.5 U/gHgb)
C 3 COMPLEMENT - 82.0 (range 83 - 180 mg/dL)
C 4 COMPLEMENT - 13.4 (range 10.0-40.0 mg/dL)
ANTINUCLEAR ANTIBODY, IFA POSITIVE (range negative)
ANA (ANTINUCLEAR ANTIBODY) PATTERN 1 - 2+ SPECK
ANTINUCLEAR ANTIBODY TITER, PATTERN 1 >80,<320
CREATINE KINASE - 39 (range <= 200)

Thank you for any and all advice. This forum has been very helpful.

 
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Old 05-18-2013, 04:25 PM   #2
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Re: Should I start Plaquenil? Just diagnosed with SLE- have included lab tests

Welcome! I can only say that Plaquenil has helped me greatly since being dx'ed over 10 years ago. Over many years, I had widespread pain (joints & shins), migraines, GI & urinary problems, low WBC, elevated ESR, etc. My skin rashes were the last symptom to arrive. I started at 200 mg twice daily, then reduced to 200 mg daily after 1-1/2 yrs. Even with Plaquenil, I need OTC's (like Advil) for pain. Also, scrupulous sun protection/avoidance is a must for me (my rashes were horribly photosensitive).

I remember only a few small side effects when starting Plaquenil. I'd heat up like a furnace about an hour after taking it, and my vision had some "halo effect" at night. Also some minor nausea. But these problems resolved pretty quickly. Because of the VERY SMALL risk for melanin buildup on the retina, my rheum still requires me to have a field vision test every six months. (BTW, such buildup, when it VERY RARELY occurs due to Plaquenil, almost always reverses if the drug is dc'ed, which wasn't true of some of the earlier antimalarials. That's one reason Plaquenil is considered a much safer drug.)

The goal in taking Plaquenil is to suppress creation of autoantibodies BEFORE they wreak damage, esp. to major organs---also to avoid, if possible, needing stronger drugs like steroids, which have more & worse side effects than Plaquenil has.

Personally, I'd want to know what specific type of lesions I had, but I'd probably not delay starting Plaquenil, given your lab results & skin problems.

When you see the dermatologist, ask him/her to spell out the rules on sun exposure. You do NOT want any discoid (scarring) lesions, esp. on your face or scalp. I learned the hard way that people with lupus are "eligible" for multiple rashes. I had many years of SCLE annular (nonscarring) on upper arms & back, but also got a large scarring discoid on my face that required surgery because it was open & refused to heal.

Glad you found us & hope you keep in touch. There's always someone here when you want to talk. Let us know how you're doing, OK? Best wishes, Vee

 
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Old 05-18-2013, 07:21 PM   #3
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Re: Should I start Plaquenil? Just diagnosed with SLE- have included lab tests

Having the Smith antibody positive helped you get diagnosed much quicker than most people do. I have had lupus 30+ years, and have found Placquenil to be very helpful with no side effects whatsoever for me. It does take 2-4 months to notice improvement, but skin involvement is one of the symptoms that responds best to it. You are getting diagnosed and treated early, without delay, which is very good, and may save you from developing some of the other possible symptoms. Placquenil is usually the first step in lupus treatment, so I would feel safe trying it.

 
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