Women with lupus can safely become pregnant, say doctors

Women suffering from lupus can safely become pregnant and also breastfeed their newborns, but the pregnancies need to be planned in consultation with doctors, said experts at the AIIMS, Delhi. Planning the pregnancy can ensure that their drugs can be modified well in advance, the experts elaborated. 

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Systemic Lupus Erythematosus (SLE) is an autoimmune rheumatic disease that affects mostly women in their reproductive age. It can involve any organ of the body and, if not treated, can be life threatening also. Symptoms of the SLE include fever, oral ulcers, skin rashes, joint pain, hair fall and kidney involvement. 

At a patient education program themed ‘Patients with Lupus also can lead a normal life’ organised at AIIMS, Delhi for SLE patients on Saturday, doctors highlighted that regular follow-up with uninterrupted treatment is the key for long-term remission in this chronic rheumatic disease.

Dr Ranjan Gupta, associate professor in the department of Rheumatology at AIIMS Delhi, said pregnancy is a major concern among lupus patients coming to the hospital as they are mostly women in their child-bearing age. The problem is further compounded by the fact that the medicines used in the treatment of SLE can cause deformities in children if taken during conception. Therefore, an unplanned pregnancy can be a physical and emotional challenge for these patients, Gupta said. 

“On the other hand, if pregnancies are planned well in consultation with their rheumatologists according to the disease state, the drugs can be modified well in advance and women patients with SLE can not only have successful pregnancy but can also breastfeed their newborns,” he said on the sidelines of the AIIMS event. The drugs that are usually used to treat SLE like mycophenolate and cyclophosphamide are deformity-causing drugs in the developing foetus and need to be changed much in advance of conception. 

Dr Gupta emphasised on early recognition of this disease by general physicians as most of the patients already accrue irreversible damage before reaching big institutes. He also called for strong family and emotional support for these patients. 

Dr Siddharth Jain, assistant professor in the department of Medicine at AIIMS, pointed towards strong female preponderance of this disease, mostly in their child bearing age, which adversely impacts not just the patient but the family as well. Early detection followed by regular treatment is the key to favourable long-term prognosis, he stressed. 

“These patients also can lead a normal life provided they visit their doctors regularly and continue the prescribed treatment. Most of the time, the disease flares are the outcomes of non-compliance,” Dr Jain said. Almost 80 patients attended the programme, which was inaugurated by the dean (Academics) Dr Kaushal Verma and HOD of Transplant Immunology and Immunogenetics, 
Dr D K Mitra. 

A nationwide programme INSPIRE, which is a cohort of 2,500 SLE patients across India in 10 institutes under the leadership of Dr Amita Agarwal, head of department of Clinical Immunology and Rheumatology at SGPGIMS, Lucknow, has been studying this disease in Indian patients since 2018. Almost 60 per cent patients from this cohort found their telephonic conversation with the researchers of this project helpful in managing their disease during the covid-19 pandemic, Dr Gupta said.

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