Patient Articles

Systemic Lupus Erythematosus

What Is Systemic Lupus Erythematosus?

Systemic lupus erythematosus (SLE) is also simply called lupus. It is an autoimmune disease. This means that the immune system attacks the cells of your own body. In lupus, cells in almost any part of your body can be attacked.

What Are the Symptoms?

Because lupus can work against many different parts of the body, people may have very different symptoms. Some people have problems with their kidneys, liver, heart, brain, or lungs. Others have problems with their skin, joints, or with blood clotting. Lupus can also cause hair loss, fatigue, or very cold hands and feet.

Many years ago, it was thought that lupus was very rare, perhaps affecting only one of a hundred thousand people. Now it is known that lupus may affect one out of a thousand. Some ethnic groups, such as black patients and Hispanic patients, may be even at higher risk.

Lupus may be a mild or severe disorder. Hearing the diagnosis is scary for many patients. However, most patients with lupus can live fairly normal lives, and not suffer any major damage to their organs.

Some patients will have more severe illness, and for these patients, aggressive treatments may be needed to control the disease. It is rare for patients who start with mild illness to progress on to more severe illness. A severe sun exposure can cause a progression, so it is important to heed the advice to be cautious about sun exposure. Not all patients are sun sensitive. Only about a third of lupus patients are sensitive to the sun, and these patients must be careful.

What Causes Lupus?

We do not know what causes lupus. But we do know that it is not contagious. Having family members (eg, mother, sister, or daughter) with lupus makes you more prone to get it. About 90% of people with lupus are women. Lupus may get worse during pregnancy. Therefore, estrogen may be involved.

What Is the Treatment?

Most people with lupus have fairly mild disease. Not everyone with lupus needs treatment. They just need to exercise, eat a healthy diet, and avoid being in the sun for long periods of time.

People having problems with internal organs, such as the kidneys, may need to use high doses of medications. It is very important to have regular checkups, because lupus can change.

Because people with lupus can have many different symptoms, there are many medications. You will not need all of these! Your doctor and you will find which one(s) work best for you.

  • Prednisone - This is a corticosteroid for people who have problems with internal organs. It should be taken for the least amount of time necessary. Taking it over long periods of time, can make you gain weight and have osteoporosis, cataracts, high cholesterol, or unhealthy blood sugar levels.
  • Hydroxychloroquine (Plaquenil®) - This medication can help take care of skin and joint problems in lupus. It is less expensive and has few side effects. But it takes a while (maybe three to six months) for you to see maximal benefits. Side effects include digestive complaints, skin rash, and changes in your vision. You need to see an eye doctor (ophthalmologist) once each year, when you take this medication.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) - These medications help relieve muscle and joint pain. They include ibuprofen (Advil®), naproxen (Aleve®), and diclofenac (eg, Voltaren®). Even though these medications are available without a prescription, they can have side effects. These include stomach ulcers and bleeding.  If taken for a long time, they can cause heart, kidney, or liver disease.
  • Azathioprine (Imuran®) - Azathioprine is often used by people with a moderate type of lupus. It works by slowing down your immune system. You need to have regular blood tests. This will make sure that your immune system works just right. Tell your doctor, if you think you have an infection.
  • Methotrexate - Many people with lupus get methotrexate. You take this medicine once each week. It is available as a pill or as an injection. People tend to have few side effects. But you should never take it while pregnant. Drinking alcohol when taking methotrexate can make it toxic to your liver. You need regular blood tests to make sure this medications works well for you.
  • Mycophenolate mofetil (CellCept®) - This is one of the best medications for people with lupus who also have kidney problems. It slows down your immune system. Therefore, it can make you more prone to infection. You need regular blood tests when taking this medication.
  • Cyclophosphamide (Cytoxan®) - This medicine is used to treat cancer. But it is also used to help people with lupus. It has serious side effects. It can make you nauseated, lose your hair, and become more prone to infection. It also can cause bladder problems. Only people who are very sick need this medication.
  • Other treatments - When the treatments above do not work, Rituximab (Rituxan®)or plasmapheresis may be used.

Lupus Resources

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