Lupus

Systemic lupus erythematosus (SLE) is a chronic condition that causes systemic inflammation affecting multiple organs. SLE commonly begins in women of childbearing age, though it can also start in childhood. The disease is more prevalent and often more severe in African Americans and Asians. Approximately 20% of SLE cases develop in children or teenagers, known as childhood-onset SLE (cSLE).

Symptoms of SLE can be non-specific and include fever, fatigue, weight loss, blood clots, and hair loss. Pregnant women with SLE may experience miscarriages, and the disease can flare during pregnancy, affecting the outcome. Nearly all lupus patients have positive antinuclear antibodies (ANA). Other antibody abnormalities may include positive double-stranded DNA, anti-Smith, and antiphospholipid antibodies. Common symptoms include rashes, sores, arthritis, lung inflammation, heart inflammation, kidney issues, neurological symptoms, heartburn, stomach pain, poor circulation, and abnormal blood tests. Monitoring for renal involvement is crucial, which includes checking for high blood pressure, swollen feet and hands, puffiness around the eyes, and changes in urination.

The primary treatment goals are to suppress the overactive immune system, induce remission, and prevent permanent organ damage. The choice of medication depends on the symptoms and may include hydroxychloroquine (Plaquenil), steroids, and immunosuppressants. The FDA has approved additional treatments such as belimumab, voclosporin, and anifrolumab for SLE. Each medication comes with potential side effects, which should be carefully managed by a healthcare provider.