1. Introduction
A 13-year-old girl, faced a challenging health journey that began at age 12. She presented with recurrent fever, severe headaches, and neck swelling, with her condition worsening despite multiple treatments. Over time, she developed additional symptoms, including dry cough, weight loss, hair loss, skin patches, and joint pain. After consulting multiple hospitals, including AIIMS and CMC Vellore, she was ultimately diagnosed with Systemic Lupus Erythematosus .
2. Patient Information
Name: XX
Age: 13 years
Gender: Female
Her health issues began at age 12, presenting initially with fever, headaches, and painful lymph node swelling. Despite initial treatments at Rainbow Hospital, her condition worsened, leading to a month-long hospitalization in October, where a biopsy was suggested but declined. Further consultations revealed gallbladder stones, weight loss, skin changes, and joint pain, culminating in a diagnosis of Systemic Lupus Erythematosus (SLE) at CMC Vellore.
By September, she developed recurrent fever, severe headaches, and painful swelling in the right side of her neck. Initially diagnosed with a viral disease at Rainbow Hospital in Vijayawada, she was given Dolo 65 and azithromycin, which provided only temporary relief. However, her symptoms soon returned with a persistent dry cough. By October, her condition worsened, leading to a month-long hospitalization at Rainbow Hospital. Although doctors suggested a lymph node biopsy, her family chose to seek a second opinion at AIIMS Hospital.
At AIIMS, her condition continued to decline. She experienced significant hair loss and lost 4 kgs within a month. Pink spots and white scaly patches appeared on her hands and legs, causing further concern. Investigations revealed she had gallbladder stones (10.7mm) and persistent joint pain, especially in the mornings and during winter, indicating a systemic issue. A visit to CMC Hospital in Vellore finally provided a diagnosis: Systemic Lupus Erythematosus, a chronic autoimmune disease.
3.Medication History:
| S.No | Present medication | Medication (After treatment) | Mechanism of the drug |
| 1 | Pantoprazole sodium sesquihydrate 40mg (1-0-0) | (1/2-0-0) | Pantoprazole is a proton pump inhibitor (PPI) that works by inhibiting the H+/K+ ATPase enzyme in the stomach lining. |
| 2 | Prednisolone 30mg (3-0-0) | (3-0-0) | It binds to the glucocorticoid receptor inhibiting proinflammatory signals and promoting anti-inflammatory signals. |
| 3 | Hydroxychloroquine sulfate 150mg(0-0-1) | (0-0-1) | Inhibits protein synthesis in susceptible organisms by inhibiting DNA and RNA polymerase. |
| 4 | Calcium carbonate and vitamin D3(0-0-1) | (0-0-1) | Supplements |
| 5 | Calcirol soft gel – once in a month | ONCE IN A MONTH | Calcirol soft gel delivers vitamin D, enhancing calcium absorption in the gut, improving bone health and immune function. |
The prognosis with the tapered medication regimen appears positive. Pantoprazole’s reduced dosage should maintain acid suppression while minimizing side effects. Prednisolone, continuing at the same dosage, will manage inflammation effectively. Hydroxychloroquine, unchanged, will consistently inhibit protein synthesis in susceptible organisms. Daily calcium carbonate and vitamin D3 will support ongoing bone health, while monthly Calcirol soft gel will ensure adequate vitamin D levels for optimal calcium absorption and immune function. This regimen, if followed correctly, should lead to improved health outcomes and symptom management.
4. Naturopathic and Lifestyle Interventions :
- Dietary Management: Anti-inflammatory diet, herbal supplements (Turmeric, Ashwagandha), yoga, and mindfulness practices.
- Lifestyle Modifications: Stress management techniques, improved sleep hygiene, and regular hydration.
5.Results and Follow Ups:
| S.No | Parameter | Day 1 | Day 20 |
| 1 | HEMOGLOBIN | 11 | 12.7 |
| 2 | LYMPHOCYTE AC | 62 | 5.36 |
| 3 | VITAMIN B-12 | 185 | 440 |
| 4 | ALKALINE PHOSPHATASE | 61.4 | 57.9 |
| 5 | FERRITIN | 6.9 | 2.9 |
| 6 | HOMOCYSTEINE | 21.7 | 14.14 |
| 7 | CORTISOL | 3.64 | 5.37 |
Following 20 days of naturopathy and yogic interventions, notable improvements in biomarkers reflect enhanced health outcomes. Hemoglobin increased from 11 to 12.7, indicating improved oxygen-carrying capacity. Vitamin B-12 levels rose significantly from 185 to 440, supporting better energy and metabolic function. Homocysteine levels dropped from 21.7 to 14.14, suggesting reduced cardiovascular risk. Alkaline phosphatase slightly decreased to 57.9 from 61.4, reflecting stable liver and bone health. However, ferritin levels decreased from 6.9 to 2.9, indicating potential iron deficiency, while cortisol levels increased, which may require further monitoring. Overall, these changes highlight the positive impact of holistic approaches on health.
6.Discussion:
Her health has significantly improved after 20 days of naturopathy and medical treatment. Her biomarkers have shown positive changes, and her clinical symptoms, including joint pain and skin lesions, have alleviated. With ongoing medication and lifestyle adjustments,her prognosis is favorable, allowing her to regain energy and return to a more active lifestyle. Regular follow-ups are necessary to monitor her condition and ensure continued progress.
7.Conclusion:
Addressing her chronic symptoms, including recurrent fevers, joint pain, and skin changes, the holistic treatment focused on reducing systemic inflammation and enhancing immune modulation. Dietary modifications emphasized anti-inflammatory foods, aiding digestion and alleviating gallbladder concerns. Regular therapeutic fasting and detox protocols supported lymphatic drainage and reduced swelling. Hydrotherapy and yoga therapy targeted joint stiffness and morning discomfort, restoring mobility. Herbal supplements, like turmeric and ashwagandha, further supported her immune system. Over time, Sanjana experienced a remarkable reduction in her symptoms, regained her vitality, and achieved a balanced state of health without invasive procedures.
EULAR Score Summary:
- Constitutional Symptoms: Fever and weight loss (Recovered).
- Musculoskeletal Symptoms: Joint pain (moderate, relief post-treatment).
- Cutaneous Symptoms: Skin patches (mild, improved).
- Neurological Symptoms: Headaches (mild, improved).
- Renal Involvement: No significant involvement (negative)
Before treatment, the patient experienced a range of symptoms affecting various systems of the body. These included fever and weight loss, along with moderate joint pain that significantly impacted daily activities. Skin patches and mild headaches also contributed to overall discomfort. Despite these challenges, renal involvement was notably absent, as all tests returned negative results.
After undergoing treatment, the patient showed marked improvement. Constitutional symptoms such as fever and weight loss were completely resolved. Musculoskeletal symptoms, particularly joint pain, saw moderate relief, while cutaneous symptoms like skin patches and neurological complaints, including mild headaches, showed notable improvement. Renal health remained unaffected, with no significant issues reported.