Lupus Diagnosis and Treatment

Diagnosis

Diagnosing 'Lupus' can be difficult because of its behaviour. No case of lupus is the same and therefore the diagnosis process and the treatment regime are also different. As lupus tends to affect any part of the body, symptoms do vary depending upon the organ involved or affected. Also, the common manifestations observed in lupus simulate other medical conditions as well. This make diagnosis often a tedious process for the Rheumatologist to rule-out other possibilities and eventually confirm it as Lupus. The most widely adopted approach to diagnosing Lupus is a combination of thorough evaluation of the symptoms via questionnaires and assessments along with blood work and clinical review.

Your doctor may evaluate through following ways before they can conclude the diagnosis is Lupus or not:

Learning about your symptoms and other changes noticed in your body/behavior in recent times
Evaluating symptoms according to the criteria from American College of Rheumatology
Blood tests that help to identify low blood count, antinuclear antibodies, Complement proteins (C3/C4), etc.
Urine tests that include complete urine examination, 24 hours urinary protein, protein to creatinine ratio to understand if there is any kidney involvement.
Imaging studies like Chest X-ray, Ultrasound or ECG which look for signs of inflammations in lungs/heart.

Further evaluations may be suggested based on the clinical outcomes of above tests or symptoms being experienced.

Treatment

Fact Statement

The undeniable fact is that Lupus is not curable and the only way to manage this disease is to control the immune system and help you feel better by improving your symptoms. The treatment regime is again dependent on the symptoms, or the organs involved and each individual person has a different line of treatment. The main intent of the treatment is to reduce organ damage, prevent the recurrence of flares, and help subside the symptoms for a better well-being.

Line of Treatment

The commonly used medications pertain to below listed categories or therapeutic areas

Non-steroidal Anti-inflammatory Drugs (NSAID) are those categories of medicines intended to reduce the inflammation which is one of the major complaints in lupus patients. These NSAIDs help you deal with fever, joint pains, swelling etc. and are essential part of maintenance therapy.
Corticosteroids or commonly called, steroids are another crucial category of medicines prescribed for Lupus patients. These corticosteroid or cortisone like medicines mimic the natural anti-inflammatory hormone called cortisol. These are potent drugs that rapidly suppress the inflammation but do come with some set of side-effects. They are generally used in high doses at initial stages or during lupus flare however, very minimal or no steroid usage is required during the remission phase or for maintenance.
Anti-malarial drugs mainly Hydroxychloroquine is known to prevent the recurrence of lupus flare apart from the relief it offers from skin rashes or joint pains.
Immunosuppressants act by suppressing your immune system and ideally recommended in serious cases of lupus wherein there is a high incidence of organ damage. Patients under immunosuppression therapy are easily prone to infections as the immune system’s ability is considerably lowered. Patients undergoing treatment through these medicines should be cautious and take necessary measures to avoid any such issues.
Monoclonal antibodies like Benlysta/Rituximab are a breakthrough drugs that limits the amount of abnormal B cells which is one of the triggering factors for production of autoantibodies (antibodies that target body’s own tissues). These medicines are higher generation drugs which are recommended or saved to be used in serious cases where normal/first line drugs are not proving to be beneficial.

Lupus Diagnosis and Treatment

Diagnosis

Treatment

Fact Statement

Line of Treatment

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