A 32-year-old woman presents with photosensitivity, malar rash, oral ulcers, and arthritis. ANA is 1:320 speckled. Anti-dsDNA is positive. C3 and C4 are low. She is planning pregnancy. Which medication is the safest to continue throughout pregnancy for lupus maintenance?
- A Methotrexate
- B Mycophenolate mofetil
- C Hydroxychloroquine ✓
- D Cyclophosphamide
Correct answer: C. Hydroxychloroquine
Explanation
Hydroxychloroquine is safe and recommended throughout pregnancy in SLE to prevent flares and improve outcomes. Methotrexate and mycophenolate mofetil are teratogenic and must be stopped at least 3 months before conception. Cyclophosphamide is reserved for severe organ-threatening disease and is not used for maintenance in pregnancy planning.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.