Lupus Diagnosis and Treatment

What is Lupus?

Also called Systemic Lupus Erythematosus (SLE), Lupus is an autoimmune disease that affects the body in a variety of ways. Lupus engages the body’s immune system to attack healthy tissue, particularly the skin, joints, and internal organs. Because Lupus is a chronic, autoimmune disorder, it can manifest in a variety of ways and cause a host of symptoms that vary in degrees of severity. 

The true root cause of Lupus is still unknown, but many scientists and doctors have linked underlying causes to a combination of genetics and environment. Inherited genetic factors may cause an individual to be predisposed to developing Lupus but the autoimmune disorder may not make itself known until external factors draw it out. 

Other risk factors may include sex, race, and age. SLE is most commonly diagnosed in individuals between the ages of 15-45 and women are more likely to develop it than men. Lupus disproportionally affects Hispanics, African-Americans, and Asian-Americans. 

Risks and Symptoms

The severity of Systemic Lupus Erythematosus can run the gamut from promoting mild, almost unnoticeable symptoms to chronic, life-threatening conditions that demand medical treatment. For those already suffering from autoimmune disorders or other illnesses, Lupus can exacerbate conditions and seriously diminish one’s quality of life or life expectancy. 

Lupus has the potential to affect nearly every part of the human body and do severe damage to internal organs and their functions if left untreated. For the most part, individuals living with Lupus don’t experience symptoms from the disease on a daily basis but instead suffer when flare-ups occur. These flare-ups can last for days to weeks. Some symptoms may retreat on their own while others may require medical attention.

The most common symptoms include: 

• Skin rashes. A tell-tale sign of Lupus often appears as a butterfly-shaped rash spread across the bridge of the nose. Itchy rashes may also pop up on any other part of the body as well. Skin rashes are one of the first ways doctors can accurately diagnose Lupus. 
• Fever. Those with Lupus often can tell a flare-up is coming because of a spike in body temperature – sometimes upward of 100 degrees. 
• Joint pain. Lupus is known to attack the joints, causing swelling, stiffness, and general pain in the knees, elbows, neck, and shoulders. Muscle and joint pain can occur along with stiffness, making it difficult for those experiencing an SLE flare-up to work and exercise. 
• Photosensitivity. Many individuals suffering from Lupus are incredibly sensitive to light. Both indoor lighting and outdoor sunlight can trigger rashes, weakness, pain, and fatigue. 
• Oral ulcers. Painful spots along the gums, cheeks, and on the roof of the mouth are an inconvenient symptom of Lupus, although not always painful. These sores can make eating and drinking difficult. 
• Chest pain. When Lupus affects the body’s internal organs – particularly the lungs – chest pain can become a frequent occurrence. Breathing, sneezing, and coughing become painful and laborious. 
• Weakness and fatigue. Despite getting enough sleep, eating right, and exercising, those with Lupus often experience severe bouts of fatigue. Even daily activities can exhaust them, making it extremely difficult to have a good quality of life. Fatigue can also signal an oncoming SLE flare-up. 
• Losing hair. Hair loss on the scalp or body is a common symptom of Lupus. Those experiencing SLE may notice losing more hair in the shower, patchy, hairless spots on legs and arms, or even noticeable bald spots on their scalp.
• Weight gain. Lupus interferes with all sorts of regulatory systems within the body. Decreased kidney function can cause weight gain and a spike in blood pressure. 
• Blood clots. High blood pressure, kidney, and heart issues can be contributing factors to blood clots forming in the legs or lungs. When and if these clots break free, they may cause a stroke or heart attack. Clotting can cause all sorts of negative responses throughout the body and is one of the more serious symptoms of Lupus. 
• Anemia. When the bloodstream is devoid of red blood cells, oxygen can’t effectively reach internal organs. This causes anemia, which then may trigger muscle weakness and fatigue.  

Lupus is especially dangerous when left untreated. For those who receive a quick diagnosis and get started on a treatment plan, Lupus can be effectively managed. However, when undiagnosed or misdiagnosed, Lupus can wreak havoc on the afflicted individual, causing numerous, chronic health problems. 

For those experiencing any symptoms related to Lupus, consulting your trusted Orlando rheumatologist can help you receive treatment quickly. 

Treatment Options and Long Term Effects

Systemic Lupus Erythematosus isn’t a death sentence. Many individuals live long, happy lives with their Lupus under control. However, those suffering from this autoimmune disorder will need to be under routine medical care and closely monitor this disease throughout their entire life. 

Receiving an early diagnosis can mitigate the damaging effects that Lupus could have on a person’s internal organs. Access to health care and a relationship with a trusted primary care doctor can alleviate mental and physical stressors when trying to manage systemic lupus erythematosus. 

If left undiagnosed for a long period of time, SLE can negatively impact the nervous system and cause lasting organ damage. Kidney problems and heart diseases are just two serious yet long-term side effects caused by Lupus. The Lupus Foundation of America prioritizes raising awareness for the early diagnosis and subsequent treatment of Lupus. 

While seemingly benign, fatigue is actually the most impactful symptom that people with Lupus deal with on a day-to-day basis. Fatigue can severely affect one’s quality of life, including holding down gainful employment. Raising a family, caring for a home, and more can be incredibly difficult when one doesn’t even have the energy to get out of bed. 

Certain SLE treatment options may be unavailable to individuals because of their current life situation. Adhering to immunosuppressant drug regimens isn’t possible for pregnant women or those trying to become pregnant. Thus, many women have to suffer months of lupus symptoms when trying to conceive and bear children. 

Common Treatments for Lupus

A multi-team approach is usually required when it comes to diagnosing, treating, and managing SLE. Because this disease uses the immune system so effectively, it can impact a number of vital organs and processes. A multi-disciplinary approach may be needed to reverse the harmful effects done to the body’s internal mechanisms. 

Corticosteroids and Immunosuppressive Drugs

Once the initial symptoms of Lupus are under control, a comprehensive health care plan can be laid out to help the patient manage the autoimmune disorder. Corticosteroids and immunosuppressive drugs are standard pieces of typical SLE treatment plans, although they do come with certain side effects. Osteoporosis is just one of the side effects that may occur with a treatment plan involving corticosteroids. 

Immunosuppressive drugs halt the immune system, stopping it from doing further damage to healthy tissue. When used in conjunction with corticosteroids (like prednisone), high doses of immunosuppressive drugs have been shown to effectively reduce Lupus flare-ups. The immunosuppressive drug, belimumab, was recently approved by the FDA, making history as the only approved biological agent for the treatment of SLE. 

Other common immunosuppressive drugs are: 

• Methotrexate
• Azathioprine
• Benlysta (belimumab)
• Mycophenolate mofetil

Pain and Swelling Management

NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen, can alleviate much of the inflammation caused by Lupus. Treating pain, stiffness, and swelling with NSAIDs is a relatively low-risk option with few side effects, and over-the-counter meds, including ibuprofen and naproxen, are widely available and affordable. In certain cases, higher doses of naproxen may be attained through a prescription only. 

The antimalarial drug, Hydroxychloroquine (plaquenil), is sometimes used to treat mild to moderate cases of SLE. Plaquenil can also reduce swelling in the knees, neck, and shoulders while keeping skin rashes at bay. 

Consulting a Rheumatologist

Because lupus can dramatically impact the joints, a doctor who specializes in rheumatology may be able to compile a lupus management plan. The Lupus Foundation of America reports that 65% of lupus patients report that chronic pain is the most trying symptom, greatly impacting their livelihood and mental health. A Rheumatologist may be better equipped to help Lupus patients deal with and manage chronic pain, including muscle stiffness and joint swelling. 

Lupus patients often have to attack the chronic disease from two angles – stopping the immune system’s inaccurate response and combating pain and discomfort from lupus-related symptoms. For some, wearing sunscreen all over the body can reduce the likelihood of skin rashes and flare-ups while others take great care to eat clean and avoid stressful situations. 

Unfortunately, because Lupus creates such a plethora of varied physical symptoms, people can often suffer for years without a diagnosis. Certain symptoms, including fatigue, chest pain, and fever, can often be attributed to common allergies while joint pain and swelling are often misdiagnosed as rheumatoid arthritis. 

Currently, researchers are attempting to identify the first sign of Lupus through blood tests, urine tests, and more. However, they have not yet succeeded in pinpointing the exact markings of the disease’s onset. 

Long term effects of Lupus can vary depending on when the individual started treatment. For those with rashes, skin scarring is a likely possibility. Kidney damage, eye problems, and hair loss may linger as long term effects. 

Those with Lupus often suffer long term effects in the form of mental health issues, including stress. Waiting for a flare-up to occur, enduring a flare-up, and recovering from a flare-up are all contributing factors to an individual’s stress levels. Missing work, relying on others for help running daily life, and not being able to keep a regular routine can severely inhibit an optimistic mindset. 

Be Proactive and Take Action

Lupus is often diagnosed through the rashes it creates on the face and body. Knowing the early warning signs, genetic predisposition, and environmental triggers can prompt one to consult with a doctor early on, instead of waiting for other symptoms to develop. 

It’s incredibly important to recognize lupus early before it begins to harm our bodies and impact daily life. If you’ve noticed an odd rash in conjunction with other Lupus symptoms, schedule an appointment with an Orlando Rheumatologist immediately. Whether or not your condition requires additional consultations, our practice has a team of experts that include dermatology and primary care providers that can help with additional treatment and long-term management

UCF Health’s patient portal offers in-depth information about autoimmune disorders, COVID-19 updates for patients, and so much more. Plus, scheduling an appointment online has never been easier. Stay on top of your overall health care plan and establish a personal relationship with a primary care doctor to promote a healthy, happy quality of life.