Sponsored by Lupus Foundation of America, Piedmont Chapter

Because many symptoms of systemic lupus erythematosus (SLE) mimic those of other illnesses, lupus can be a difficult disease to diagnose. The diagnosis of lupus is based off of a combination of physical symptoms and laboratory results and for most people is not a one time diagnosis. More often than not it is a diagnosis that evolves over time either towards more certainty that a person does or does not meet the criteria for a diagnosis of lupus. So what is your doctor looking for to help determine if you may have lupus?

A doctor who is considering the possibility of lupus will look for signs of inflammation. The signs of inflammation are pain, heat, redness, swelling, and loss of function at a particular place in the body. Inflammation can occur on the inside of your body (your kidneys or heart, for example), on the outside (your skin), or both.

However, there are many challenges in confirming that a person has lupus and not some other disease. Lupus is known as "the great imitator," because its symptoms mimic many other illnesses. Also, lupus symptoms can be unclear, can come and go, and can change. Therefore, a lupus diagnosis is made by a careful review of:

• your current symptoms
• your laboratory test results
• your medical history
• the medical history of your close family members (grandparents, parents, brothers and sisters, aunts, uncles, cousins)

All of this information may be necessary for a doctor to make a diagnosis of lupus because, for a number of reasons, laboratory tests alone cannot give a definite "yes" or "no" answer.

• No single laboratory test can determine whether a person has lupus.
• Test results that suggest lupus can be due to other illnesses, or can even be seen in healthy people.
• A test result may be positive one time and negative another time.
• Different laboratories may produce different test results.

Sponsored by Lupus Foundation of America, Piedmont Chapter

Because the symptoms of lupus vary from one person to another, the treatment of the disease is tailored to the specific problems that arise in each person. In many cases, the best approach to treating your lupus is with a health care team.

Today, doctors are using a wide variety of medicines to treat lupus -- ranging in strength from mild to extremely strong. It is not unusual for the prescribed medications to change during a person’s lifetime with lupus. However, it can take months, and sometimes years, before your health care team finds just the right combination of medicines to keep your lupus symptoms under control.

People with lupus are generally treated by a rheumatologist, a doctor who specializes in diseases of the joints and muscles. If lupus has caused damage to a particular organ, other specialists will be consulted as well, such as a dermatologist for cutaneous lupus (skin disease), a cardiologist for heart disease, a nephrologist for kidney disease, a neurologist for brain and nervous system disease, or a gastroenterologist for gastrointestinal tract disease. An obstetrician who specializes in high-risk pregnancies will be needed when a woman with lupus is considering a pregnancy.

Once you have been diagnosed with lupus, your doctor will develop a treatment plan based on your age, symptoms, general health, and lifestyle. The goals of any treatment plan are to:

• reduce inflammation caused by lupus
• suppress your overactive immune system
• prevent flares, and treat them when they occur
• control symptoms like joint pain and fatigue
• minimize damage to organs

Managing lupus is a team effort. And since there often will be several physicians involved in your care, good communication is necessary among members of your health care team.

• Lupus is also a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better). Lupus can range from mild to life-threatening and should always be treated by a doctor. With good medical care, most people with lupus can lead a full life.
• It is believed that there are at least 1.5 million Americans and 5 million people throughout the world who have a form of lupus.
• Lupus strikes mostly women of childbearing age (15-44). However, men, children, and teenagers develop lupus, too.
• Women of color are 2-3 times more likely to develop lupus.
• People of all races and ethnic groups can develop lupus.
• More than 16,000 new cases of lupus are reported annually across the country.