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YOUR HEALTH: New hope for lupus patients who are pregnant

DURHAM, North Carolina – About 1.5 million people in the United States suffer from lupus.   It mostly strikes women of childbearing age, putting them at a higher risk of miscarriage and premature delivery.

Sometimes Emily Greenwell can't believe she gave birth to this beautiful baby boy named Finley.

"Nine pounds and he was 22 and a quarter inches long."

Emily has lupus: a chronic autoimmune disease that can damage the skin, joints and organs.    It can also cause inflammation.

"We'll see kidney inflammation which can cause kidney failure in some situations, explained Dr. Megan Clowse, Associate Professor of Medicine, Division of Rheumatology & Immunology at Duke University.

She says for years women with lupus were warned not to get pregnant because they would have to stop the medications that controlled the disease.

"I know now we have come to sort of a new approach to lupus pregnancy management," said Dr.  Clowse.

Dr. Clowse says keeping lupus well controlled during pregnancy is key.

"My approach here at Duke, I continue almost everybody on hydroxychloroquine."

Also known as plaquenil, Dr. Clowse says the drug has been shown to be safe during pregnancy.

"I have managed about 150 lupus pregnancies over the past decade. We have probably about 30 percent of our pregnancies deliver early."

She says those pre-term births tended to occur in women who got pregnant while their lupus was active.

"So in my experience plan the lupus pregnancies," she said.

MEDICATIONS:   Dr. Megan Clowse says doctors can prescribe some medications that can be pretty effective, but she says they don't really have enough medications to fix everything.   "Hydroxychloroquine is the medicine that we use the most.  It's also called plaquenil.  It's a medicine that's been around for decades", she explained.  Dr. Clowse has managed 150 lupus pregnancies over the past decade.   For women who are pregnant with lupus, she says, "know that hydroxychloroquine can be continued. Azathioprine can be continued. Prednisone can be continued and should probably be continued.   The medicines I recommend stopping are Methotrexate; that should be stopped right away.   Also mycophenolate and cyclophosphamide or Cytoxan."

Emily was carefully monitored by her doctor the entire time.  She says she never had a flare-up during her pregnancy and felt great.

Now the proud parents of a healthy baby boy, Emily and her husband Moxie say despite the lack of sleep it's all worth it.

"Every day is a different day and it`s been amazing."

Dr. Clowse says if you have lupus and get pregnant unexpectedly call your doctor's office right away and tell them the medications you are taking because some may cause birth defects and should be stopped immediately.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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