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UT Southwestern Medical Center’s Rheumatology Program is recognized as one of the nation’s leading clinical and research centers for lupus and other rheumatic diseases. Our ongoing advances in developing diagnostic tests and therapies for this chronic condition help control patients’ symptoms and reduce the risk of developing serious complications.
Leading-Edge Care for Lupus
Systemic lupus erythematosus (SLE or simply “lupus”) is an autoimmune disease that can impact many different organ systems. It can affect the joints; tendons and other connective tissues; and organs such as the kidneys, heart, lungs, brain, and blood vessels.
Many patients are women in their late teens to mid-40s – peak reproductive years. This is thought to be due to estrogen’s role in the disease’s development and activity. However, men, children, and older adults also develop lupus. The disease is more prevalent among African Americans, Hispanics and Latinos, Asians, Native Americans, Alaska Natives, and Native Hawaiians and other Pacific Islanders than it is among Caucasians.
UT Southwestern is at the forefront of patient care and research for lupus. Our experienced rheumatologists partner with multidisciplinary colleagues in other fields such as nephrology and dermatology to deliver comprehensive care to people with lupus. We focus on controlling symptoms and preventing the chronic health risks associated with the condition.
Signs and Symptoms of Lupus
Lupus affects each individual differently, and its effects range from mild to life threatening. Common symptoms include:
- Malar rash, a butterfly-shaped rash usually located across the bridge of the nose and the cheeks
- Discoid rash, a raised rash found on the head, arms, chest, or back
- Diffuse body rash
- Sun sensitivity
- Weight change
- Swelling of the joints and joint pain
- Chest pain caused by inflammation of the lining of the heart, lungs, or abdomen
- Hair loss
- Mouth sores or vaginal sores
- Thinking problems
- Raynaud's phenomenon, in which fingers and toes might turn blue and white and then red after cold exposure or with stress
For patients with lupus, laboratory testing might show:
- Decreased kidney function
- Low white blood cell or low platelet count
- Anemia, a lack of healthy red blood cells
- A positive antibody called an antinuclear antibody (ANA)
People with lupus might have periods of a partial or complete lack of symptoms.
Diagnosing lupus can be challenging. While the vast majority of patients with lupus have a positive ANA, the blood test does not make the diagnosis of lupus itself, as one in five healthy people have a positive ANA but fewer than one in 50 of those with a positive ANA have lupus. In addition, people with lupus can present in many different ways, and symptoms can be vague.
Our specialists at UT Southwestern have expertise in diagnosing lupus. In addition to taking a thorough medical history and performing a comprehensive physical examination, doctors might order a number of studies.
Blood testing is commonly used to:
- Assess blood counts and platelet counts
- Evaluate kidney function
- Detect antibodies that are present in most people with lupus
- Measure other markers of immune activation such as complement
- Look for markers of inflammation such as the c-reactive protein and the erythrocyte sedimentation rate (sed rate)
- Evaluate kidney function with a urinalysis and blood test
A small tissue sample (biopsy) might be taken to look for signs of damage or inflammation. This is most commonly done with the skin and the kidneys.
How patients with lupus are treated depends on disease severity and organ involvement.
- Nonsteroidal anti-inflammatory medications (NSAIDs) can be used to treat joint pain and inflammation of the lining of the lungs and heart.
- All patients, unless contraindicated, should be treated with an antimalarial drug such as hydroxychloroquine.
- Corticosteroids can be used to control inflammation.
- Disease-modifying drugs are used to treat skin and joint disease.
- Immunosuppression and biologics are used to treat kidney disease.
Other ways to manage the disease include:
- Limited sun exposure with liberal use of sunscreen, decreased time outdoors between 10 a.m. and 4 p.m., and wearing hats and long sleeves when outdoors
- Adequate sleep and rest
- Smoking cessation
- Stress reduction
- Eating a well-balanced diet
Treatment for lupus and its related complications depends upon:
- Severity and extent of the condition
- Patient age, overall health, and medical history
- Organs affected
- Expectation for the course of the disease
- Patient preferences and tolerance for medications, procedures, and therapies
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