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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18651
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have a severe case of lupus. One of the worst problems is

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I have a severe case of lupus. One of the worst problems is thick, thick, thick clear mucus. I never get colds. The mucus has a huge blood clot only in morning. My nasal passages are always clear, unless I cry. I swallow so much mucus that I start to vomit. No stomach problems (just tons of bloody mucus as seen by endoscopy), never smoked or drank, take 5mg Coumadin daily. I also take 400mg dilantin for seizures, 25mg pred, 4mg. medrol, 5 mg flexerol. Tried musinex. When I took that I woke, drowning in a sea of snot. Nose still perfectly clear.
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Is the mucus draining from the nose or sinuses or coming up from the chest?
What evaluation has been done for the mucus?
Customer: replied 3 years ago.

Drainage is from sinuses. Not coming up from chest, or running out nose. Drs. have looked at mucus, but because it is predominantly clear, they have done nothing. I NEVER have had a cold or the flu. I have pleurisy that has been kept in check by pred.

Thank you for the additional information.

It is true that there is no need to treat clear mucus from the sinuses. The mucus can become infected and would require treatment. But if there is no infection, the issue of treatment is based solely on how bothersome the mucus is.

You are already taking the usual primary treatment for the mucus - steroids, such as prednisone and medrol. However, when there is inflammation from lupus that does not respond well to a steroid, the next consideration would be whether to use a medicine that suppresses the immune system, such as cyclophosphamide or azathioprine. Since the stronger medicines also carry more potential for side effects, many doctors would prefer to avoid using these medicines for sinus mucus. It is more common that these medicines may be needed if the lupus is affecting the lungs, but not as common for the sinuses. However, if the problem is of such severity that something must be done, one of these medicines would be the next consideration.

If you need any clarification, please let me know.
Customer: replied 3 years ago.

I am currently taking azathioprine. Do you think that adding cyclophosphamide might help this. I live in Colorado, so you can see that I have had NO sleep from this mucus.

Thanks, Dawn

It would usually be used instead of the azathioprine, rather than n addition to the azathioprine. It might help, as different people will respond better to different medicines. Overall, the two medicines are about equivalent, but may work better for particular individuals.
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Customer: replied 3 years ago.

Thank you very much. Mucus is not generally taken seriously, and you.


You're welcome. I hope that you can get some relief.