Lupus (Systemic Lupus Erythematosus)

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Topic Overview

What is systemic lupus erythematosus, or lupus?

Lupus is an autoimmune disease, which means that the body's natural defense system (immune system) attacks its own tissues instead of attacking foreign substances like bacteria and viruses. This causes inflammation. Inflammation causes swelling, pain, and tissue damage throughout the body. If you develop severe lupus, you may have problems with your kidneys, heart, lungs, nervous system, or blood cells. Lupus is the common name for systemic lupus erythematosus, also called SLE.

Although some people with lupus have only mild symptoms, the disease is lifelong and can become severe. But most people can control their symptoms and prevent severe damage to their organs. They do this by seeing their doctors often for checkups, getting enough rest and exercise, and taking medicines.

This topic focuses on systemic lupus erythematosus (SLE), the most common and most serious type of lupus. But there are four other types of lupus: discoid or cutaneous lupus, drug-induced systemic lupus, neonatal lupus, and subacute cutaneous lupus.

What causes lupus?

The exact cause of lupus is not known. Experts believe that some people are born with certain genes that affect how the immune system works and that they are more likely to get lupus. Then a number of other factors can trigger lupus attacks. These include viral infections, including the virus that causes mononucleosis, and sunlight.

Although these things can trigger lupus, they may affect one person but not another person.

What are the symptoms?

Lupus symptoms vary widely, and they come and go. The times when symptoms get worse are called relapses, or flares. The times when symptoms are not so bad are called remissions.

Common symptoms include feeling very tired and having joint pain or swelling (arthritis), a fever, and a skin rash . The rash often happens after you have been in the sun. Mouth sores and hair loss may occur. Over time, some people with lupus have problems with the heart, lungs, kidneys, blood cells, or nervous system.

How is lupus diagnosed?

There is no single test for lupus. Because lupus affects different people in different ways, it can be hard to diagnose.

Your doctor will check for lupus by examining you, asking you questions about common symptoms, and doing some blood tests. It is easier for your doctor to diagnose lupus if you have the most common symptoms and your blood has certain proteins. These proteins are called antinuclear antibodies, or ANAs. But other problems can cause your body to make ANAs, so doctors will use blood tests and other tests to find out if you have lupus.

How is it treated?

Lupus is treated by:

• Applying corticosteroid cream for rashes.
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) for mild joint or muscle pain and fever.
• Taking antimalarial medicines to treat fatigue, joint pain, skin rashes, and lung inflammation.
• Taking corticosteroids if other medicines are not controlling your symptoms.

Because corticosteroids are powerful medicines and can cause serious side effects, the doctor will recommend the lowest dose that will give the most benefit.

The doctor may also recommend other medicines that slow down the immune system.

How can you manage lupus?

One of the goals of controlling mild to moderate lupus symptoms is to prevent flares, the times when your symptoms are worse. Some of the other things you can do include:

• Rest to reduce stress.
• Avoid the sun. Wear sunscreen and protective clothing when you are outside.
• Exercise regularly to prevent fatigue and joint stiffness.
• Stop smoking.
• Learn the warning signs of a symptoms flare, such as fatigue, pain, and rash, and take steps to control them.

With good self-care, most people with lupus can keep doing their regular daily activities.

It is important to learn about lupus so that you can understand how it might affect your life and how you can best cope with it. Also, help your family and friends understand your limitations and needs when your symptoms flare. Develop a support system of family, friends, and health professionals.

Frequently Asked Questions

Last updated:	May 13, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Stanford M. Shoor, MD - Rheumatology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC