Lupus

Signs & symptoms

Although the severity and range of symptoms of lupus differ for each person, common symptoms include:

• Painful or swollen joints and muscle pain
• Unexplained fever
• "Butterfly" rashes, most commonly across the bridge of nose and cheeks
• Chest pain when breathing deeply, called pleurisy
• Unusual hair loss
• Sensitivity to the sun
• Swelling, or edema, in the legs or around the eyes
• Swollen glands
• Extreme fatigue

Diagnosis

Your doctor will begin by recording your complete medical history, including a description of your symptoms. You also will undergo a physical examination to check for any physical signs of the disease. In order to make a definitive diagnosis of lupus a number of tests may be used, including the following:

• Antinuclear Antibody Test (ANA) This test identifies certain autoantibodies typically present in the blood of people with lupus. Most people with lupus test positive for ANA. However, a positive ANA result can occur due to infections and other rheumatic or immune diseases. In addition, healthy people without lupus also can test positive.
• Other Blood Tests Your doctor may order other blood tests for individual types of autoantibodies, which are more specific to people with lupus. These antibodies include anti-DNA and anti-ENA antibodies as well as serum complement levels. However, not all people with lupus have positive tests.
• Urinalysis Because lupus can cause kidney problems, your doctor may recommend an examination of your urine, called urinalysis. If elevated amounts of protein are found, you may be asked to collect all the urine you pass in a 24-hour period for analysis.
• Biopsy In certain situations, your doctor may recommend a biopsy of an affected organ, such as kidney or skin, to better help in diagnosis and treatment. A kidney biopsy requires an overnight hospital stay.

Your doctor may order a test for syphilis or anticardiolipin antibodies. A positive test does not mean that you have syphilis, but may indicate the presence of an antibody that increases the risk of blood clotting and miscarriages.

Treatments

There is currently no cure for lupus. However, for most people, effective treatment can greatly reduce symptoms and help maintain normal body functions. Treatment often includes:

• Medications to reduce inflammation and activity of the immune system
• Balancing rest with exercise
• Maintaining a healthy diet

Drug Therapy

Medications commonly used to treat lupus, include:

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) These drugs, such as aspirin and ibuprofen, may relieve muscle and joint pain as well as arthritis.
• Acetaminophen This is the main ingredient in Tylenol, a mild pain reliever.
• Corticosteroids Synthetically produced corticosteroids, such as Prednisone, are used to reduce inflammation and suppress activity of the immune system.
• Antimalarials These drugs, such as Plaquenil, help with symptoms of lupus and also may prevent major flares in other organs.
• Immunomodulating Drugs These drugs, such as Imuran, Cellcept, Methotrexate and Cytoxan, suppress the immune system. They may allow a reduction in the dose of corticosteroids.

Lifestyle Changes

For most people with lupus, making positive lifestyle changes allow them to better manage the disease and improve their quality of life. Preventive measures include:

• Regular exercise that helps prevent muscle weakness and fatigue
• Immunizations to protect against specific infections
• Lifestyle adjustments, such as getting plenty of rest, reducing stress, eating a balanced diet and quitting smoking
• Avoiding excessive sun exposure or regularly applying sunscreens in order to reduce rashes and flares in lupus