Retinal disease has a high morbidity and should be treated aggressively by an ophthalmologist. 16 , 17 Ophthalmic screening programs in SLE are controversial. Most physicians agree that patients on antimalarial or steroid regimens should receive a full dilated-eye examination on initiation of therapy then with routine examinations in low-risk patients and yearly for high-risk patients. High risk is defined by medication dosage (> mg per kg hydroxychloroquine or >3 mg per kg chloroquine), duration of use (more than five years), high body fat level, presence of renal or liver disease, presence of concomitant retinal disease, and age greater than 60 years. 16 , 18
Gammaglutamyl transferase is elevated in a number of hepatobiliary conditions (nearly all forms of biliary disease and cholestasis will be associated with a raised GGT (1)). These include:
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