Lupus - Diagnosis and Treatment (2023)

Diagnose

It is difficult to diagnose lupus because the signs and symptoms vary greatly from person to person. The signs and symptoms of lupus can change over time and overlap with those of many other conditions.

No test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis.

laboratory tests

Blood and urine tests may include:

  • Complete blood count.This test measures the number of red blood cells, white blood cells, and platelets, and the amount of hemoglobin, a protein in red blood cells. Results may indicate you have anemia, which is common with lupus. A low white blood cell or platelet count can also occur in lupus.
  • erythrocyte sedimentation rate.This blood test determines the rate at which red blood cells settle to the bottom of a tube over an hour. A faster than normal rate can indicate a systemic disease such as lupus. The sedimentation rate is not disease specific. It can be elevated if you have lupus, an infection, another inflammatory disease, or cancer.
  • Kidney and liver assessment.Blood tests can assess how well your kidneys and liver are working. Lupus can affect these organs.
  • urine analysis.Examination of a urine sample can show an increase in the level of protein or red blood cells in the urine, which can occur if lupus has damaged your kidneys.
  • Antinuclear antibody (ANA) test.A positive test for the presence of these antibodies produced by your immune system indicates a stimulated immune system. While most people with lupus test positiveAlsoTest, most people with a positive resultAlsoI don't have lupus if it tests positiveAlso, your doctor may recommend more specific antibody tests.

imaging tests

If your doctor suspects lupus is affecting your lungs or heart, he or she may suggest the following:

  • chest x-ray.A picture of your chest may show abnormal shadows that indicate fluid or inflammation in your lungs.
  • echocardiogram.This test uses sound waves to create real-time images of your heartbeat. It can find problems with your valves and other parts of your heart.

Biopsy

Lupus can damage the kidneys in many different ways, and treatments can vary depending on the type of damage occurring. In some cases it is necessary to analyze a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision.

Sometimes a skin biopsy is done to confirm a diagnosis of lupus, which affects the skin.

More information

  • Antinuclear antibody (ANA) test.
  • Complete Blood Count (CBC)
  • echocardiogram
  • liver function test
  • Sed rate (blood sedimentation rate)
  • urine analysis
  • bone scan

Treatment

Treatment for lupus depends on your signs and symptoms. To determine if you should receive treatment and what medications to use, you need to carefully discuss the benefits and risks with your doctor.

(Video) Lupus: Symptoms, Risk factors, Pathophysiology, Diagnosis and Treatments.

As your signs and symptoms wax and wane, you and your doctor may need to change your medications or dosages. The most commonly used drugs to control lupus are:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs).At the counterAINEDrugs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), can be used to treat pain, swelling, and fever associated with lupus. StrongerAINEThey are available by prescription. side effects ofAINEThese can include stomach bleeding, kidney problems and an increased risk of heart problems.
  • antimalarial drugs.Drugs commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), affect the immune system and may help reduce the risk of lupus flare-ups. Side effects can include upset stomach and very rarely damage to the retina of the eye. Regular eye exams are recommended when taking these medications.
  • Corticosteroids.Prednisone and other types of corticosteroids can counteract the inflammation from lupus. High doses of steroids, such as methylprednisolone (Medrol), are often used to control serious diseases affecting the kidneys and brain. Side effects include weight gain, easy bruising, bone loss, high blood pressure, diabetes, and an increased risk of infection. The risk of side effects increases with higher doses and longer duration of therapy.
  • immunosuppressants.Drugs that suppress the immune system can help in severe cases of lupus. Examples include azathioprine (Imuran, Azasan), mycophenolate (Cellcept), methotrexate (Trexall, Xatmep, others), cyclosporine (Sandimmune, Neoral, Gengraf), and leflunomide (Arava). Possible side effects can include an increased risk of infection, liver damage, reduced fertility and an increased risk of cancer.
  • Biological.Another type of drug, belimumab (Benlysta), given through an IV, also reduces lupus symptoms in some people. Side effects include nausea, diarrhea and infections. Rarely, depression can get worse.

    Rituximab (Rituxan, Truxima) may be beneficial for some people who have not been helped by other medications. Side effects include allergic reactions to the intravenous infusion and infections.

In clinical trials, voclosporin has been shown to be effective in treating lupus.

Other potential drugs to treat lupus are under investigation, including abatacept (Orencia), anifrolumab, and others.

Ask for an appointment

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clinical trials

Explore the Mayo Clinic studiesTesting new treatments, interventions, and tests as a means of preventing, detecting, treating, or treating this condition.

lifestyle and home remedies.

diagnosis and treatment

Take steps to take care of your body when you have lupus. Simple steps can help you prevent flare-ups of lupus and, if they do occur, better manage the signs and symptoms you're experiencing. Attempt:

  • Visit your doctor regularly.Regular checkups, rather than just seeing a doctor when your symptoms worsen, can help your doctor prevent flare-ups and can be helpful in addressing routine health issues like stress, diet, and exercise, which can help prevent complications from lupus.
  • Be smart with the sun.Because ultraviolet light can trigger a flash, wear protective clothing such as a hat, long-sleeved shirt, and long pants, and use sunscreen with a sun protection factor (SPF) of at least 55 when you go outside.
  • Do sports regularly.Exercise can help keep your bones strong, reduce the risk of a heart attack, and promote overall well-being.
  • no fumesSmoking increases the risk of cardiovascular disease and can worsen the effects of lupus on the heart and blood vessels.
  • Eat healthy.A healthy diet emphasizes fruits, vegetables, and whole grains. Sometimes you may have dietary restrictions, especially if you have high blood pressure, kidney damage, or gastrointestinal issues.
  • Ask your doctor if you need vitamin D and calcium supplements.There is some evidence that people with lupus may benefit from vitamin D supplementation. Calcium supplementation can help you meet the recommended daily allowance of 1,000 milligrams to 1,200 milligrams, depending on your age, to keep your bones healthy.

alternative medicine

Sometimes people with lupus seek alternative or complementary medicine. There are no alternative therapies proven to alter the course of lupus, although some may help relieve the disease's symptoms.

Discuss these treatments with your doctor before starting them yourself. He or she can help you weigh the benefits and risks and tell you if the treatments will adversely affect your current lupus medications.

Complementary and alternative treatments for lupus include:

  • Dehidroepiandrosterona (DHEA).Taking supplements containing this hormone along with conventional treatment may help reduce flare-ups of lupus.DHEAIt can cause acne in women.
  • fish oil.Fish oil supplements contain omega-3 fatty acids, which may be beneficial for people with lupus. Preliminary studies have shown promise, although further studies are needed. Side effects of fish oil supplements can include nausea, belching, and a fishy taste in the mouth.
  • Acupuncture.This therapy uses tiny needles that are inserted just under the skin. It can help relieve muscle pain associated with lupus.

coping and support

If you have lupus, you're likely to experience a range of painful feelings related to your condition, from fear to extreme frustration. The challenges of living with lupus increase the risk of depression and related mental health problems, such as anxiety, stress, and low self-esteem. To help you cope, try the following:

  • Learn all about lupus.Write down any questions you have about lupus as they come to mind so you can ask them at your next appointment. Ask your doctor or nurse for reliable sources of additional information. The more you know about lupus, the more confident you'll feel about your treatment options.
  • Gather support from your friends and family.Talk to your friends and family about lupus and tell them how they can help you with flare-ups. Lupus can be frustrating for loved ones as they usually cannot see you and you may not appear sick.

    Family and friends can't tell if you're having a good day or a bad day unless you tell them. Be open about how you feel so your loved ones know what to expect.

    (Video) Systemic Lupus Erythematosus (SLE): Symptoms, Diagnose And Treatment | Rheumatology

  • Take time for yourself.Manage the stress in your life by making time for yourself. Use this time to read, meditate, listen to music, or write in a journal. Find activities that soothe and refresh you.
  • Connect with other people who have lupus.Talk to other people who have lupus. You can connect through support groups in your community or through online message boards. Other people with lupus can offer unique support because they face many of the same obstacles and frustrations as you.

Preparing for your date

You'll likely see your GP first, but you may be referred to a specialist in the diagnosis and treatment of inflammatory joint disease and immune disorders (rheumatologists).

Because the symptoms of lupus can look like many other health issues, you may need to be patient while you wait for a diagnosis. Your doctor will need to rule out a number of other diseases before diagnosing lupus. Depending on your symptoms, you may need to see multiple specialists, such as: B. Doctors who treat kidney problems (nephrologists), blood disorders (hematologists), or disorders of the nervous system (neurologists) to help you diagnose and treat them.

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

  • When did your symptoms start? Do they come and go?
  • Does anything seem to be triggering your symptoms?
  • Did your parents or siblings have lupus or other autoimmune diseases?
  • What medications and dietary supplements do you take regularly?

You can also write questions for your doctor, such as:

  • What are the possible causes of my symptoms or condition?
  • What tests do you recommend?
  • If these tests don't identify the cause of my symptoms, what additional tests might I need?
  • Are there any treatments or lifestyle changes that can relieve my symptoms now?
  • Do I have to follow any restrictions while we seek a diagnosis?
  • Should I see a specialist?
  • If you are thinking of becoming pregnant, be sure to discuss it with your doctor. Some medicines must not be used if you become pregnant.

In addition to whatever questions you might want to ask your doctor, don't hesitate to ask questions during your appointment if you don't understand something.

What to expect from your doctor

Your doctor will likely ask you a number of questions. Being willing to answer them can allow time to go through any points you want to spend more time on. Your doctor may ask:

  • Does sun exposure cause skin rashes?
  • Do your fingers become pale, numb or uncomfortable in the cold?
  • Do your symptoms include problems with memory or concentration?
  • How much do your symptoms limit your ability to function at school, work, or in personal relationships?
  • Have you been diagnosed with any other medical conditions?
  • Are you pregnant or planning to become pregnant?

By Mayo Clinic staff

21. October 2022

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