44   years old female pateint 
open heart surgery  in 2011    for  valve  replacement 
she  is knonw to have  SLE       for the last   14  years 

recurrent  abortion  and 
she has  no   proteuria   untill 


she is  on reguler follow up  by  dr  muath 
plaquneil 200 mg once   1x2 
myfortic  360 mg 2x2 
prograf    hal f  tab   x2 
mepral    20 mg onc e
prendsione  n 10 mg ocne 
coumadin   5 mg once daily 
concor  5 mg one 
valsan   160 mg once   
 

she was referred to us  for   cyclophosphamdei   500 mg    every   2 weeks 

plan 
add     prendisone  20 mg ocne 
prograf
j dee 
myfortic  360 mg  2   and  1   and  2 
rtc after one month