From the Guidelines
Lupus symptoms should be managed with a multidisciplinary approach, focusing on controlling disease activity, preventing organ damage, and optimizing health-related quality of life, as outlined in the 2019 EULAR recommendations 1. The symptoms of lupus can vary widely, but commonly include fatigue, joint pain, skin rashes, and fever.
Key Symptoms
- The hallmark sign is a butterfly-shaped rash across the cheeks and nose, affecting about half of lupus patients.
- Other symptoms include:
- Sun sensitivity
- Hair loss
- Mouth sores
- Chest pain during deep breathing
- Raynaud's phenomenon (fingers turning white or blue in cold) Lupus can also cause kidney problems (indicated by swelling in legs or around eyes), cognitive issues like memory problems or confusion, and blood disorders such as anemia or increased clotting risk.
Disease Management
These symptoms often come and go in "flares" triggered by factors like sun exposure, stress, or certain medications. The disease is autoimmune, meaning the immune system mistakenly attacks healthy tissues throughout the body, causing inflammation and damage to various organs. According to the EULAR recommendations, treatment goals include long-term patient survival, prevention of organ damage, and optimization of health-related quality of life 1. If you experience persistent unexplained symptoms, especially several occurring together, consult a healthcare provider for evaluation, as early diagnosis and treatment can help manage symptoms and prevent organ damage, as suggested by the 2008 EULAR recommendations 1.
Prognosis and Monitoring
New clinical manifestations, laboratory tests, and immunological tests may provide prognostic information for the outcome in general and involvement of major organs, and thus should be considered in the evaluation of these patients 1. Confirmation by imaging and pathology may add prognostic information and should be considered in selected patients 1. The 2019 EULAR recommendations emphasize the importance of a shared patient-physician decision and consideration of individual, medical, and societal costs in SLE care 1.
From the Research
Lupus Symptoms and Management
- Lupus is a chronic inflammatory autoimmune disease with a wide range of clinical presentations resulting from its effect on multiple organ systems 2.
- The disease can affect various parts of the body, including the skin, joints, kidneys, and other organs 2.
- Patients with lupus experience a loss of self-tolerance as a result of abnormal immunological function and the production of autoantibodies, which lead to the formation of immune complexes that may adversely affect healthy tissue 2.
Treatment and Management Options
- Synthetic drugs are prescribed for nearly all patients with systemic lupus erythematosus (SLE) to ameliorate symptoms and positively influence outcome 3.
- Hydroxychloroquine should be considered an anchor drug in SLE because of the multiple beneficial effects of this agent 3.
- Lifestyle interventions, such as physical exercise, diet and nutrition, mental health, and photoprotection, can be beneficial in managing SLE symptoms and improving quality of life 4.
- Psychological interventions have a positive effect on depressive symptoms, anxiety, and health-related quality of life (HRQoL), whereas physical exercise improves fatigue, depressive symptoms, aerobic capacity, and physical functioning 4.
Current Treatment Perspectives
- The current therapeutic options for SLE include biologics, combination therapies, and immunosuppressive drugs 5.
- The treat-to-target strategy aimed at reducing or discontinuing therapy with glucocorticosteroids (GCs) is important in refining their dosage and obtaining a better safety profile 5.
- Recent clinical research data requires continuous consolidation to optimize patient outcomes, and the European Alliance of Associations for Rheumatology (EULAR) recommendations provide guidance on the treatment of SLE 5.