Case 2: 48-year-old woman

• A 48-year-old woman with an 18-year history of SLE is presenting for a regular appointment
• • Mother of 2 teenage children, works full time as a dental assistant
  • Functional history: patient describes worsening of her lupus symptoms 
  • • Pain in fingers, especially in the winter, causing some functional disability
    • Hip pain causing difficulty walking
• Treatment history
• • Heavy steroid use before switching to methotrexate and belimumab 12 years ago
  • 18-year history of hydroxychloroquine with no ocular adverse events