Women's Health

Lupus

In this factsheet:
• The Facts on Lupus
• Causes of Lupus
• Symptoms and Complications of Lupus
• Diagnosing Lupus
• Treating and Preventing Lupus

Diagnosing Lupus

An antinuclear antibody (ANA) test is the most important test for lupus, as almost all people with lupus will have elevated blood levels of antinuclear antibodies. However, a diagnosis will not be based on ANA results alone, because many people have positive ANA tests without lupus, and it can also occur in other autoimmune diseases. A person with a positive ANA test who does not have clinical signs or other lab abnormalities has about a 5% chance of developing full-blown lupus in their lifetime.

Your medical history and a physical examination done by your doctor will play an important role in making the diagnosis. Other laboratory studies such as tests of kidney function, as well as joint X-rays and MRI (magnetic resonance imaging) scans, will help determine the extent of the disease.

People may need heart tests and an electroencephalogram (a test to measure electrical activity of the brain) to detect neurolupus (lupus that affects the brain).

Treating and Preventing Lupus

The use of medication to treat lupus depends on the severity of the disease. In some cases, medication may not even be necessary.

Commonly prescribed medications include:

• painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) - some of these medications are available over-the-counter, but check with your doctor or pharmacist before starting one
• hydroxychloroquine* is used, although it is often in combination with other medications to help control lupus
• oral corticosteroids are the main treatment for most cases - this type of medication will help to reduce inflammation and its symptoms
• immunosuppressive agents (e.g., cyclophosphamide, mycophenolate, azathioprine) suppress the immune system from attacking the body's organs and tissues - these are used when the kidney, brain, or other major organs are involved

Although all of these medications can be helpful and sometimes even life-saving, they have potentially very serious side effects. You should discuss the benefits and risks carefully with your doctor. You may also want to discuss your medications with health care professionals who are experienced in their use, such as rheumatologists (doctors who specialize in the diagnosis and treatment of arthritis and other diseases that affect the joints, muscles, and bones).

For those who have lupus, the following tips may be helpful:

• Consult a rheumatologist. Rheumatologists have the most experience and expertise in diagnosing and managing lupus in its many forms.
• Pregnancy can sometimes trigger the onset of lupus or it may worsen it if you already have lupus, but in other cases the disease may not be affected by pregnancy. If you have lupus and are planning to become pregnant, or if you develop lupus while pregnant, you should be under the care of both an obstetrician or gynecologist experienced in high-risk pregnancy as well as a rheumatologist.
• Get plenty of rest and relaxation.
• Learn stress management methods.
• Receive regular medical and dental care.
• Participate in regular moderate exercise.
• Maintain a healthy, balanced diet.
• Do not smoke.
• Maintain vitamin D levels well within the recommended guidelines.
• Don't take over-the-counter medications without the advice of a health professional.
• If you're taking corticosteroids and other immune-suppressing medications, report any signs of infection to your doctor.
• Avoid excessive exposure to the sunlight's ultraviolet rays - wear hats, sunglasses, and long-sleeved clothing and use a sunscreen with a sun protection factor (SPF) of at least 15 that protects against both ultraviolet A and B (UVA and UVB) light.
• Consider joining a support group to help cope with various aspects of the condition.
• Inform yourself as much as possible about lupus.

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.