Diagnosing lupus can be difficult and requires sophisticated training and experience. The board-certified physicians at Norton Rheumatology Specialists treat lupus patients in the Louisville area and Southern Indiana.
Autoimmune diseases such as lupus can affect the whole body. Part of an effective treatment plan means working with specialists in orthopedics, heart and vascular, gastroenterology, and more who are part of Norton Healthcare’s comprehensive system.
Lupus is an autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs, causing widespread inflammation. This inflammation can affect many different systems — including joints, skin, kidneys, blood cells, brain, heart and lungs.
Lupus can be mistaken for rheumatoid arthritis and other conditions. Rheumatoid arthritis tends to attack the joints, while lupus will go after connective tissue anywhere in the body.
Diagnosing lupus requires sophisticated rheumatology trainings. There is no single test for lupus, and diagnosis typically starts with ruling out other conditions. Certain antinuclear antibodies are often in the blood of lupus patients. A negative antinuclear antibody test can rule out lupus, and a positive result can provide clues to the diagnosis.
Biopsies of affected organs may be necessary as well. Diagnosing lupus requires a broad picture of your health, medical history, symptoms and the results of various tests.
Lupus can be difficult to diagnose because its signs and symptoms often look like those of other disorders. Every case of lupus is different. Symptoms may be mild or severe, come on quickly or develop over time, and may be temporary or permanent. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus.
The American College of Rheumatology has developed a guide of symptoms that can help determine a lupus diagnosis.
- Rashes – A butterfly-shaped rash on the face that covers the cheeks and bridge of the nose, also known as a malar rash. Discoid rashes with raised, round or oval patches and rash on sun-exposed skin are also signs.
- Mouth sores – Sores on the mouth or nose that last more than a few days and sometimes more than a month
- Arthritis – Tenderness and swelling lasting for a few weeks in two or more joints
- Cardiopulmonary inflammation – Swelling of the tissue lining the lungs (pleurisy) or the heart (pericarditis), which can cause chest pain when breathing deeply
- Poor kidney function – Blood or protein in the urine. Tests also can point to poor kidney function
- Neurologic conditions – Seizures, strokes or psychosis
- Blood test results – Anemia, low white blood cell counts or low platelets; evidence of antinuclear antibodies are present in nearly all lupus patients; or abnormal antibodies such as anti-double-strand DNA, anti-Smith or antiphospholipid antibodies
What Causes Lupus?
Some people have a genetic tendency toward developing lupus. It can be triggered by infections, certain drugs or even sunlight.
Lupus is more common in women and people between the ages of 15 and 45. It is also more common in African Americans, Hispanics and Asian Americans.
Lupus can be managed with treatment, but there is no cure. Treating lupus revolves around improving symptoms, preventing flare-ups and heading off additional conditions often caused by lupus.
Your Norton Rheumatology Specialists rheumatologist will work with you to develop a treatment plan based on your symptoms and your treatment goals.
Your lupus treatment may change as your symptoms change. Medications commonly used to treat lupus include:
- Over-the-counter nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen help reduce mild pain and swelling.
- Prednisone (steroids) can help reduce swelling and pain and calm the immune system. Lupus symptoms often respond quickly to steroids, leading to a tapering off of your dosage.
- Two antimalarial drugs used to treat lupus are hydroxychloroquine and chloroquine phosphate. Studies found that taking antimalarial medicine can stop lupus flares and may help people with lupus live longer.
- BLyS-specific inhibitors limit the amount of abnormal B cells. These cells, which create antibodies, often are found in lupus patients. Belimumab blocks a protein in the body that is important in immune response.
- Immunosuppressive agents and chemotherapy can help in severe cases of lupus, but can also lower the body’s ability to fight infections.