| 초록 |
Treatment is in itself associated with morbidity, the effects of which may be permanent. The patient and family must cope with a chronic, unpredictable disease that ranges widely in severity. For the physician and other health care providers, the challenge is not only to provide the most appropriate pharmacologic care but also to ensure the health of the child in the broadest sense and to help the child and family cope with the effects of the disease and its treatment. Specific treatment should be individualized and based on the extent and severity of the disease. Pharmacologic management of SLE in children is the mainstay. NSAID is to treat musculoskeletal complaints. Hydroxychloroquine is given as an adjunct to therapy with glucocorticoids. Without doubt, glucocorticoids constitute the mainstay of pharmacologic therapy. Immunosuppressive agents are often required to control SLE. A choice of immunosuppressive agent is made among azathioprine, cyclophosphamide, methotrexate, cyclosporine, and mycophenolate mofetil. The management of specific aspect of acute hemolytic anemia, antiphospholipid syndrome, central nervous system disease, lupus nephritis and dyslipopro-teinemia are more difficult conditions. Although SLE is a serious, life-threatening disease, optimistic approach to the care of these children is now justified to control the disease. But the prognosis is poorest in patients with diffuse proliferative nephritis or persistent CNS disease. Sepsis is the most common cause of death. |
