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House Call: Lupus diagnosis, treatment

Published: Jul. 31, 2020 at 6:43 PM EDT
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Lupus is a disease that can affect people of all ages, races, and ethnicities. The signs and symptoms mimic those of other diseases, making it hard to diagnose. Joining us tonight for part one of a two part series concerning lupus is Aaradhana Kaul, MD, rheumatologist with UHC Rheumatology.

1). What is lupus?

Lupus is a chronic, autoimmune disease that affects many different parts of the body. An autoimmune disease occurs when the body’s immune system attacks itself because it cannot tell the difference between healthy tissue and foreign invaders, such as bacteria and viruses. This process creates inflammation in various parts of the body.

In the US, at least 1.5 million people have lupus and about 16,000 new cases of lupus are reported each year. Lupus can affect all ages, gender and racial or ethnic groups. However, some people are at higher risks than others-such as young reproductive females, people with a family history of lupus and certain ethnic groups such as African American, Asian American and Hispanics.

2). What are the signs and symptoms of lupus?

Lupus symptoms can show up in many different ways and it is often mistaken for symptoms of other diseases. This is why it can be hard to diagnose and it is often called “the great imitator.” Lupus symptoms can range from mild to life threatening, so early diagnosis and treatment by a rheumatologist are important. A rheumatologist is a doctor who has additional training and experience in the diagnosis and treatment of arthritis, lupus, and other diseases of the joints, muscles, and bones.

Symptoms can include: Fatigue, muscle and joint pain or swelling, skin rashes (in particular a butterfly-shaped face rash across the cheeks and nose), fever, hair loss, recurring mouth sores, sensitivity to the sun, chest pain with deep breaths, fingers or toes turning blue or white when cold, dry eyes, kidney failure, seizure, stroke or psychosis, and blood disorder and abnormal clotting.

People with Lupus can have periods of symptoms called flares, followed by symptom-free periods called remissions. They may have flares often, or years apart, throughout their life and with varying severity.

3). How easy or difficult is it to diagnose?

Lupus can be hard to diagnose because it is a complex disease with varied symptoms that can come on slowly. Lupus may also be misdiagnosed, so it is important to see a doctor who specializes in rheumatology. On average it takes nearly 6 years for people with lupus to be diagnosed, from the time they first notice their lupus symptoms.

To diagnose it, we take into account the patient’s symptoms and signs observed during physical exams, and the results of lab and X-ray tests. Sometimes we even need biopsy of affected organs as well. The most important blood screening test is called ANA. If ANA is negative then it is unlikely to be lupus.

4). What do treatment options look like for lupus?

Although there is no cure for lupus, it can be managed with proper treatment, and people with lupus can go on to live long, happy lives. The goals of treatment are to manage current symptoms, prevent flares, and prevent damage to joints and organs by suppressing the overactive immune system. Because the symptoms of lupus vary widely, management depends on a person’s individual symptoms and needs.

Common treatment options include antimalarial drugs like hydroxychloroquine or plaquenil, nonsteroidal anti-inflammatory drugs like ibuprofen, steroids and immune suppressants.

Seeing a doctor regularly and following the prescribed course of treatments is important. Beyond that, adopting healthy behaviors and learning skills to manage the disease can also be beneficial.

For more information on lupus or to schedule an appointment, please contact UHC Rheumatology, located on the UHC Campus, by calling 681-342-3490 or you can go to our website at www.wvrheumatology.com.

Make sure you join us next week for part two of our interview concerning lupus.

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