Which of the following drugs was most likely included in the therapeutic management of this patient?
A 28-year-old woman was admitted to the hospital with fever, a malar butterfly erythema, arthralgia, intermittent pleuritic pain and oral ulcers. Her lab tests revealed the following: serum creatinine 5.2 mg/dL, BUN 35 mg/dL, and high serum level of antinuclear antibodies.
A. Infliximab B. Prednisone C. BCG vaccine D. Interferon-beta-1b E. Aldesleukin
Prednisone-answer: b(koda-kimble, pp 44-3, katzung, pp 651)the sings and symptoms of the patients strongly indicate that she is affected by lupus erythematosus infact the patient shows five of the 11 sings and symptoms most often associated with this disease (malarbutterfly erythema, arthritis, oral ulcers, renal disorder, nuclear antibodies). according to the americancollege of rheumatology the diagnosis of lupus erythematosus is made when the patient has 4 or moreof these 11 signs and symptoms.the cause of lupus erythematosus is unknown but it is thought to involve autoimmune mechanisms.therefore the therapy almost always includes corticosteroids that are especially valuable for the moresevere and life threatening manifestations of the disease. since in the present case there are sings ofrenal insufficiency (see creatinine and bun values) steroid therapy is strongly indicated.a) infliximab is currently approved for use in rheumatoid arthritis and crohns disease.c, d, e) these are immunostimulant drugs and therefore are would be contraindicated in autoimmunedisease.