Treatment and Management of Lupus (Systemic Lupus Erythematosus)

How is lupus diagnosed?

Many people with lupus feel frustrated and angry because they have been ill for months or even years before they are told they have lupus. It is often difficult to diagnose early in the disease. Lupus symptoms are similar to those of other diseases and can come and go even without treatment. In addition, all other possible causes for the person’s symptoms must be investigated before treatment for lupus can begin.

To receive a diagnosis of lupus, four or more of the following signs and symptoms must occur:

• Rash over the cheeks (malar or butterfly rash)
• Round raised patches (discoid rash) usually on the scalp or ears
• Sensitivity to the sun or other ultraviolet light
• Ulcers or sores in the mouth
• Pain and swelling in joints associated with inflammation
• Inflammation around the lungs or heart
• Kidney problems
• Problems in the nervous system such as seizures, strokes or psychosis
• Abnormalities in the blood such as low blood counts
• Abnormalities in the immune system that are determined by blood tests
• Antinuclear antibodies (ANA) in the blood

The diagnosis of another type of lupus, Discoid Lupus, can be made when a person only has a patchy, round rash, and no other symptoms. Blood tests and a skin biopsy are helpful in making this diagnosis. People with discoid lupus may or may not progress to systemic lupus erythematous.

How can lupus symptoms be managed?

The goal of treatment is to relieve pain, control inflammation and prevent damage to vital organs. Medications are very helpful and are prescribed depending on the severity of symptoms and the organs that are involved. Lifestyle changes can help decrease symptoms, as well. These changes can include getting extra rest during a flare, reducing stress and avoiding sun exposure with clothing and/or sunscreen. Medications and lifestyle changes can control lupus symptoms in most people.

Lupus and Heart Disease

Recent evidence suggests that patients with lupus may have an increased risk of heart attacks as compared with the general population. This may be due to the chronic inflammation triggered by the disease but the cause is not entirely understood. Because of this risk, people with lupus should try to stay healthy and avoid smoking cigarettes. 
 

This information has been approved by JoAnn Gillis, MD (April 2008).