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Systemic Lupus Erythematosus

June 18, 2013

Not LupusTechnical Description

Systemic lupus erythematosus (SLE) presents arthralgia, erythematous (butterfly) facial-malar skin rash, erythematous hands, light sensitivity, oral and nasal ulcerations, anemia, leucopenia, serositis (e.g. pericarditis), renal glomerular injury and neurological changes (headaches, mood swings, etc.).

What are the warning signs of Lupus?

 Pain in the muscles and joints of the hands, arms, shoulders, feet, knees, hips or jaw. The pain may move from area to area and may cause the skin to feel hot, display redness or swell
 Fever and loss of appetite
 Low energy and fatigue
 Skin rashes, often on the face. Sometimes the rash is across the cheeks and bridge of the nose; this is called a butterfly rash. Sometimes the rash is red and scaly and appears on the face, scalp, ears, arms or chest. A milder form of Lupus called discoid Lupus causes this type of rash.
 Small, usually painless sores in the moist lining of the mouth or nose called mucosal ulcers
 Sensitive to sunlight
 Changes in the color of the fingers when they are cold
 Sudden and unexplained weight loss or gain
 Increase in the number and severity of headaches
 Increase in loss of hair over the whole scalp
 Chest pain when lying down or taking deep breaths
 Ongoing high blood pressure
 Swelling of the feet and legs

SLE is a different disease for each person it affects because it can target any of the body’s tissues. Each person has his or her own combination of symptoms and these symptoms range from mild to severe. It’s important to remember that Lupus symptoms vary from person to person. In some people the disease will be mild with periods of activity or inflammation (flare-ups) and inactivity (remissions). In other cases the disease will be continuously active and appear to get worse or progress over time. If you have recently experienced three or more of the warning signs of SLE you may want to discuss this with your doctor.

How do doctors diagnose Lupus?

If your doctor thinks you have SLE, he or she will usually refer you to a rheumatologist. A rheumatologist is a doctor who has received specialized training in the diagnosis and treatment of problems involving inflammation of the joints, muscles and other parts of the body.

 If your doctor thinks you might have SLE or another form of Lupus, he or she may perform a physical examination and order lab tests, such as blood tests.
 There is not just one single symptom, sign or test that will give a diagnosis of SLE.
 There is no cure for SLE but there are things you can do to manage the disease.

Treatment is designed to control the symptoms and reduce the number of flare-ups. Establishing the correct diagnosis is important because something can be done to manage Lupus and most therapies work best when started early in the disease.

Diagnosis of SLE can be difficult because the symptoms vary from person to person. The symptoms can also mimic those of other medical conditions. If your doctor thinks you might have SLE or another form of Lupus, he or she may review your medical history and symptoms and may perform a physical examination and order laboratory tests, such as blood tests. It might take some time before a diagnosis is made. Usually a diagnosis can be made when there is evidence of a number of the main warning signs of SLE and other conditions that can indicate the presence of SLE:

 Pleuritis (inflammation of the lining of the lungs) or pericarditis (inflammation of the lining of the heart) may cause chest pain when lying down or taking deep breaths.
 Decreased kidney function (mild or severe) may result in weight gain or swelling of the feet and legs
 Central nervous system involvement may be exhibited by seizures or psychosis (acute disturbance in mental functioning).
 Decreased blood cell count (lower than normal amounts of circulating red blood cells, white blood cells or platelets)
 Auto antibodies present in the blood point to an abnormality in the immune system response.
 Antinuclear antibodies present in the blood.

Your doctor may reach a diagnosis of SLE after thoroughly examining the combination of symptoms, conditions and test results, and after ruling out other illnesses. There is no single symptom, sign or test that will give a diagnosis of SLE.

If you are diagnosed as having SLE, the goal of your treatment plan will be to bring the symptoms and disease under control. Some people with SLE may require no treatment if their symptoms are not severe. Treatment plans are individualized to meet each person’s needs. Your active involvement in developing your prescribed treatment plan is essential.

If you are a woman with SLE, be sure to discuss birth control methods with your doctor, as well as the best time to become pregnant. Birth control methods and pregnancy can change the level of hormones in your body, and in turn can have an impact on your SLE.

Steps should also be taken to avoid flare-ups. Each person’s pattern of Lupus flares tends to be unique. A person with Lupus may be able to detect early warning signs of flares. Early detection can lead to more effective treatment while symptoms are in the beginning stages of a flare.

A lot can be done to manage the condition. Four major treatment approaches are recognized in the management of Lupus: medicine (pharmacological), physical (exercise), joint protection, lifestyle changes and surgery. Active involvement in you prescribed treatment plan is essential.


 Exercise helps reduce pain and prevents further joint damage and can help you maintain a healthy weight, which puts less strain on your joints
 Disuse of a sore joint will cause the muscles around it to weaken, resulting in pain

Three types of exercises:
 Range of motion exercises reduce stiffness and help keep your joints moving. A range of motion exercise for your shoulder would be to slowly move your arm in a large circle.
 Strengthening exercises maintain or increase muscle strength to increase joint capsule stability. Strength training exercises include weight training.
 Endurance exercises strengthen your heart, give you energy and control your weight. These exercises include walking, swimming and cycling.

Muscles and the other tissues that hold joints together weaken when they aren’t moved enough, so the joint loses its shape and function. Exercise helps lessen the symptoms of Lupus and can help make you feel better overall. Moderate stretching exercises will help relieve the pain and keep the muscles and tendons around the affected joint stronger and more flexible. Low-impact exercises like swimming, walking, water aerobics and stationary bicycling can all reduce pain while maintaining strength and flexibility. Always consult a doctor before beginning a new exercise program.

Pacing Yourself – To allow your muscles a chance to rest
 Remember to pace yourself when doing heavy or prolonged work and do not be afraid to take frequent rests. Be kind to your body. Pacing allows weakened muscles a chance to recuperate.

Position Joints Wisely – To avoid excessive stress on bones
 Use your back, arms and legs in safe ways to avoid putting extra stress on joints. For example, carry a heavy load close to your body.
 Using helpful devices, such as canes, luggage carts, grocery carts and reaching aids, can help make daily tasks easier. Using grab bars and shower seats in the bathroom can help you to conserve energy and avoid falls. Use larger, stronger joints to carry loads. For example, use a shoulder bag instead of a handheld one.
 Avoid keeping the same position for a long period of time.
 Maintain a healthy weight to avoid putting extra stress on your joints.


Certain dietary factors can contribute to Lupus flares. Excessive use of alcohol and smoking can also trigger inflammation and increase symptoms.


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