How Is Lupus Treated
There is no cure for lupus but treatments can help you feel better and improve your symptoms. Your treatment will depend on your symptoms and needs. The goals of treatment are to:
- Treat symptoms when they happen
- Reduce organ damage and other problems
- Reduce swelling and pain
- Calm your immune system to prevent it from attacking the organs and tissues in your body
- Reduce or prevent damage to the joints
- Reduce or prevent organ damage
What types of medicines treat lupus?
Several different types of medicines treat lupus. Your doctors and nurses may change the medicine they prescribe for your lupus as your symptoms and needs change.
Types of medicines commonly used to treat lupus include:
- Nonsteroidal anti-inflammatory drugs . Over-the-counter NSAIDs, such as ibuprofen and naproxen, help reduce mild pain and swelling in joints and muscles.
- Corticosteroids. Corticosteroids may help reduce swelling, tenderness, and pain. In high doses, they can calm the immune system. Corticosteroids, sometimes just called steroids, come in different forms: pills, a shot, or a cream to apply to the skin. Lupus symptoms usually respond very quickly to these powerful drugs. Once this has happened, your doctor will lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. Stopping this medicine suddenly can harm your body.
Can I treat my lupus with alternative medicine?
Will I need to see a special doctor for my lupus?
Behind The Scenes: Blood Tests
After trained professionals take your blood, it is sent off to a lab for testing. The blood samples are kept track of throughout the process with barcodes. These barcodes dont usually tell the lab technicians much about you, but they do make sure that you receive the correct test results when they are all done.
For many tests, the blood is first spun very fast in a machine called a centrifuge. The centrifuge forces the blood to separate into two different parts: the plasma and the serum . Blood tests can use plasma, serum, or whole blood, depending on the tests.
These days, tests are usually done by a machine which does the analysis under the supervision of a lab technician. The machine can do various things, including acting as a microscope or performing chemical experiments on the blood sample. Exactly what the machine is tasked to do depends on the specifics of the test.
Quick Answers For Clinicians
Presenting symptoms of systemic lupus erythematosus are often nonspecific. In addition to arthralgia, myalgia, fatigue, weight loss, and fever, patients may present with malar rash, photosensitivity, pleuritic chest pain, Raynaud phenomenon , and mouth sores. SLE should be suspected in patients who demonstrate symptoms in two or more of these organ systems: cardiac, constitutional, dermal, gastrointestinal, hematologic, musculoskeletal, neuropsychiatric, pulmonary, renal, or reticuloendothelial.
The American College of Rheumatology recommends against performing subserology tests, or subsequent testing for autoantibodies such as anti-double-stranded DNA and anti-Smith, in patients who are negative for antinuclear antibodies and who do not have clinical indications of autoimmune disease.
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What Happens If I Get Diagnosed With Lupus
If you get diagnosed with lupus, you can work with your doctor to make a treatment plan. Theres no cure for lupus, but there are ways to stay on top of your health and manage your symptoms.
For more information about diagnosing lupus, visit the National Resource Center on Lupus.
This resource is available as a PDF in English, Spanish, and Chinese . Download now to print and share.
Three Types Of Skin Rash
Each of the three following kinds of rash constitutes one criterion for diagnosing lupus: a butterfly-shaped rash across the bridge of the nose and onto the cheeks a red or purple scaly rash on both arms, the fingers of both hands, the neck, the torso, or the legs a rash resulting from photosensitivitythat is, exposure to sunlight.
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Complement Level: C3 C4 And Ch50
The complement system is a series of proteins that assemble in domino fashion to destroy bacteria and viruses invading the body. The signal that initiates this domino cascade, or activates complement, is when an antibody meets an antigen . Because lupus autoantibodies initiate the same signal and activate complement despite the absence of an identified bacterium or virus, the measurement of complement proteins can be used to monitor lupus activity. It usually suffices to measure only two of the complement proteins, called C3 and C4. CH50, or total complement, is a blood test that measures all the complement proteins at once and may give additional information. CH50 is a much more complicated test, however, and is not routinely done.
Low C3 and C4 levels , occur in active lupus, especially when the kidneys are affected or there is immune breakdown of blood cells . Other manifestations of lupus, such as brain disease, do not cause low complement levels.
Diagnosing Systemic Lupus Erythematosus
Systemic lupus erythematosus, commonly known as lupus, is a chronic autoimmune disease. This means that the immune system, which attacks viruses and bacteria, instead attacks healthy tissue, causing inflammation throughout the body and, sometimes, damaging tissue. Lupus can affect the blood vessels, brain, joints, kidneys, heart, lungs, nervous system, or skin. Another type of lupus, cutaneous lupus, affects only the skin.
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Symptoms of lupus can range from mild to serious, depending on the organs affected. Lupus involves periodic flare-ups, in which symptoms intensify, and remission, in which symptoms lessen or disappear. The most common symptoms include fatigue, painful and swollen joints, skin rashesmost notably, a butterfly-shaped rash across the faceunexplained fever, and mouth or nose ulcers. More severe lupus can cause pleuritis, an inflammation of the lining of the lungs kidney disease neurological conditionsthose affecting the brain and spinal cordsuch as weakness or memory loss and pericarditis, an inflammation of the sac that covers the heart.
Experts dont know what causes lupus. But a family history of the disease increases risk, and hormones or chemicals may also play a role. In people with a family history of lupus, exposure to sunlight can trigger symptoms. Lupus affects 10 times more women than men and more African Americans. It is most common in women between the ages of 15 and 40.
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Urine Changes And Kidney Disease
Urine abnormalities, such as high levels of protein in the urine, can indicate that lupus has affected the kidneys. Some people develop lupus nephritis, an inflammation of the kidneys that can cause them to leak protein and blood cells into urine. Left untreated, this can lead to kidney failure.
Symptoms of kidney disease also often include swelling of the ankles, feet, legs, and, less commonly, the face or hands, as well as puffy eyes upon waking. Dark-colored and foamy urine, high blood pressure, and weight gain may also appear. After speaking with you about your symptoms, including those you may have had in the past or that come and go, your NYU Langone rheumatologist orders a series of diagnostic tests.
Blood Tests Are A Critical Part Of Detecting And Measuring Lupus Even Though Currently Available Blood Tests Dont Offer Certainty New Biomarker
When you get a blood test, a small sample of blood is taken from a vein or the finger and then analyzed. You may be asked to squeeze your hand or put a band or ribbon on your arm. This helps the clinician extract blood more easily. Otherwise, you also do not need to get ready for the blood tests listed below. There is no fasting or other preparations involved. Here is some information for if you are required to fast prior to the test.
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Understanding Symptoms Of Lupus
In autoimmune rheumatic diseases, your immune system attacks healthy tissue, which leads to inflammation that in turn causes symptoms such as joint pain and swelling.5 Connective tissue diseases and other autoimmune diseases can affect many different organs, so you may notice symptoms throughout your body.
Common lupus symptoms in women and men include6:
- Joint pain or swelling
- Chest pain when breathing deeply
- Sensitivity to sunlight or other light
- Purple or pale fingers or toes due to cold or stress
Discoid lupus Acute cutaneous lupussubacute cutaneous lupus
How Is Lupus Managed
Most people with lupus are able to manage the disease and enjoy a good quality of life with effective treatments and the decision to follow a healthy lifestyle. You will get better results if you can work closely with your doctor and specialist.
Treatment for lupus is very individual and medicines are given depending on the severity of the disease and the organs involved.
Medicine most commonly used to manage a person with lupus include:
- non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen or naproxen or Cox-2 inhibitors to reduce inflammation, muscle aches and arthritis
- medications used to treat malaria such as hydroxychloroquine and chloroquine that can also be added to reduce joint pain, skin rashes and fatigue
- corticosteroids such as Prednisolone that are very effective at reducing inflammation and will be used in higher doses to treat more serious complications of lupus, for example when the heart, lungs or nervous system are affected
- medications to suppress the immune system, such as methotrexate or cyclophosphamide, that are used for more severe disease usually under the supervision of a specialist doctor such as a rheumatologist as these medicines can have serious side effects
People with lupus need to take good care of their health, and maintain a healthy lifestyle. It’s important to monitor and control other risk factors for ill-health such as smoking, high blood pressure, high blood fats, high blood sugars and being overweight.
- getting plenty of rest
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Blood Tests Used In The Diagnosis Of Lupus
Antibodies form in the body as a response to infection. When an invader enters the body, white blood cells known as B lymphocytes react by making special types of proteins called antibodies. Antibodies are your bodys way of remembering an antigen if it enters the body again, the antibodies will recognize it, combine with it, and neutralize it to prevent you from becoming infected. However, with autoimmune diseases such as lupus, the immune system can produce antibodies that attack your bodys cells as though they were invaders, causing inflammation, damage, and even destruction. Several blood tests can be performed to detect specific auto-antibodies and help make the diagnosis of lupus. These blood tests are not conclusive by themselves, but combining the tests with certain physical findings can help to corroborate a diagnosis.
What Are The Symptoms Of Lupus
Different people have different symptoms, and one person may have different symptoms at different times. Symptoms can be vague.
Lupus can be very unpredictable. Some people have relatively few symptoms after the initial flare up, while others have periods of fairly good health alternating with flare-ups of disease.
The most common symptoms include:
- problems with tendons, causing your fingers to pull in abnormal positions
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Key Points About Lupus
- Lupus occurs more often in African Americans, Hispanics or Asian-Americans, than in other ethnic groups.
- Certain environmental factors can trigger lupus.
- Lab and imaging tests are used to diagnose Lupus.
- Treatment for lupus usually involves a combination of medicines and lifestyle changes and focuses on reducing flare-ups and symptoms.
Whether You’re Meeting In Person Or Online Here Are Some Tips For Working With Your Doctors:
- Keep track of your medical appointments and hospital visits
- Write down your symptoms as you experience them over time
- Organize any recent results from lab tests
- Bring an updated list of all your medications, including vitamins and supplementsâeven if they feel unrelated, it’s important to share everything you’re taking with your doctor
- Have questions ready for your doctor
- Wear loose-fitting clothing in case you need to show any visible symptoms
- Take a friend or family member with you to your appointment for moral support
- Ask any questions you have
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Diagnosing And Treating Lupus
Talk to your doctor if you have lupus symptoms. Lupus is a chronic disease with no cure. This means that you can manage it with treatment, but it will not go away. Treatment can help improve your symptoms, prevent flares, and prevent other health problems often caused by lupus. Your treatment will depend on your symptoms and needs.
Should I Get Blood Tests
In general, yes. Get blood tests done for lupus as recommended by your doctor.
If you are worried about side effects, only a few test tubes of blood are taken so it is rarely harmful. You may feel pain or soreness at the site. But, other side effects such as swelling, bleeding, fainting, and infection are very rare.
There are many methods to help distract you from the needle stick if that bothers you. There are even special devices that use cold and vibration to cancel out the pain of the needle. Though you should always make sure that you can handle the vibration and temperature change before using it.
Blood tests are low-risk and dont take much time. They can help confirm a diagnosis and help you better understand your unique lupus symptoms. In the end, this enables you to create a treatment plan that is right for you.
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Look Out For Symptoms
The first step in the diagnosis of lupus is to figure out your symptoms.
The symptoms of lupus vary widely between people. To confuse matters, many of the symptoms can also be caused by other conditions like diabetes or arthritis. They can even âflare upâ and then go away for no apparent reason.
These are some of the reasons why lupus can be so hard to diagnose. Still, there are some symptoms that seem to be more common with lupus.
One common symptom is a rash or rashes. You may have a typical âbutterfly rashâ that covers each cheek and joins at the bridge of your nose. Or you might have rashes elsewhere on your hands, wrists, or face. They’re often itchy and typically happen after a long time in the sun. Some may fade and some stick around for a long time.
Other common symptoms include:
C3 And C4 Reactive Protein Test
This blood test measures proteins called complement proteins in your blood. These proteins are masters at teamwork they are called complement proteins because they assist each other in tracking down, marking, and killing disease-causing organisms like bacteria. Some act like triggers for others, causing a chain reaction that protect the body. This is known as an immune system cascade.
However, in autoimmune diseases such as lupus, the whole system is turned on its head and some of these complement proteins might be tracking down, marking, and killing a persons own cells.
This is usually tested by causing a chemical chain reaction in the sample that mimics an immune response. The analyzing machine then measures how much of the complement proteins were consumed. There are many different complement proteins, labeled from C1 to C9, but the ones most commonly measured are C3 and C4. These are particularly low in people with lupus, so this test can be used to confirm lupus in at-risk people.
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Uses For Laboratory Tests
- To diagnose: Lupus symptoms often mimic those of other diseases and vice versa. Physicians use medical history, physical examination and laboratory findings to confirm the diagnosis.
- To determine prognosis: Physicians want to understand how a patients disease will progress. Laboratory tests are used to establish a baseline at the time of diagnosis and to predict whether lupus is likely to improve or worsen.
- To monitor: Laboratory tests help physicians assess the severity of the disease, the efficacy of treatment, and medication-related side effects.
- To guide therapy: Laboratory tests help physicians make treatment recommendations and adjust for changing symptoms.
Common Treatments For Lupus Nephritis Include:
Immunosuppressants: Used to treat aggressive or more severe lupus nephritis. These are powerful therapies that keep your immune system from damaging your kidneys.
Steroids: Used to quickly reduce and control inflammation of the kidneys.
Blood pressure medications: Used to lower blood pressure and may also slow the progression of kidney disease.
Antimalarials: Often used to treat lupus and has also been shown to be beneficial in the treatment of lupus nephritis.
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Your Role In Diagnosis
If youre experiencing lupus symptoms, a firm diagnosis helps you get the treatment you need. To help your care team, there are two things you can do.
1. Be prepared. Know as much as you can about your symptoms and when they appear. This helps your doctor take the appropriate next steps. Our lupus symptoms checklist allows you to document your symptoms and create a customized report to take to your appointment. The checklist can also help you track flares, and increases in lupus activity that can come and go.
2. Work with your provider. Lupus is a mysterious disease that requires many tests for diagnosis. Following a positive ANA test, talk to your provider about seeing a rheumatologist and ordering the AVISE CTD lupus test.
Take the next step and send your doctor information about AVISE CTD lupus testing.
Last reviewed by an Exagen subject expert on 08/24/2022.