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Lupus

Overview

Lupus is an autoimmune disease – a condition in which the body mistakes its own healthy tissues as foreign invaders. As a result, the body wrongly attacks its own cells, which leads to inflammation and damage to various body tissues. Lupus can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain.

Lupus affects one out of every 185 Americans, with more than 16,000 people developing the condition each year. Although lupus can occur at any age and in both men and women, 90 percent of those diagnosed with lupus are female. In addition, African Americans, Latinos, Asians and Native Americans are at an increased risk. The cause of the disorder is unknown. However, research indicates that a combination of genetic, environmental and possibly hormonal factors are involved.

Although there is no cure for lupus, effective treatment can greatly reduce symptoms and help maintain normal body functions.

Our Approach to Lupus

UCSF provides comprehensive evaluations and advanced, personalized care for lupus. Because lupus can involve different systems in the body, our team includes doctors from several specialties, such as rheumatology, dermatology, nephrology and neurology. Our providers focus on moderate to severe lupus, and have expertise in lupus nephritis and other manifestations of the condition that can damage organs.

Treatment options include medications to suppress the immune system and reduce inflammation. Antimalarial drugs also may improve symptoms and prevent major flare-ups. Many people with lupus find that lifestyle changes – such as getting sufficient sleep, adopting a more nutritious diet and exercising regularly &ndash help to manage their condition and improve their quality of life.

In addition to caring for patients, our providers conduct clinical trials to evaluate potential new treatments for lupus. Interested patients may have the option to receive investigational treatments through a clinical trial.

Awards & recognition

  • usnews-neurology

    Among the top hospitals in the nation

  • usnews-rheumatology

    Best in California and No. 7 in the nation for rheumatology

Signs & symptoms

Although the severity and range of symptoms of lupus differ for each person, common symptoms include:

  • Painful or swollen joints and muscle pain
  • Unexplained fever
  • "Butterfly" rashes, most commonly across the bridge of nose and cheeks
  • Chest pain when breathing deeply, called pleurisy
  • Unusual hair loss
  • Sensitivity to the sun
  • Swelling, or edema, in the legs or around the eyes
  • Swollen glands
  • Extreme fatigue

Diagnosis

Your doctor will begin by recording your complete medical history, including a description of your symptoms. You also will undergo a physical examination to check for any physical signs of the disease. In order to make a definitive diagnosis of lupus a number of tests may be used, including the following:

  • Antinuclear Antibody Test (ANA) This test identifies certain autoantibodies typically present in the blood of people with lupus. Most people with lupus test positive for ANA. However, a positive ANA result can occur due to infections and other rheumatic or immune diseases. In addition, healthy people without lupus also can test positive.
  • Other Blood Tests Your doctor may order other blood tests for individual types of autoantibodies, which are more specific to people with lupus. These antibodies include anti-DNA and anti-ENA antibodies as well as serum complement levels. However, not all people with lupus have positive tests.
  • Urinalysis Because lupus can cause kidney problems, your doctor may recommend an examination of your urine, called urinalysis. If elevated amounts of protein are found, you may be asked to collect all the urine you pass in a 24-hour period for analysis.
  • Biopsy In certain situations, your doctor may recommend a biopsy of an affected organ, such as kidney or skin, to better help in diagnosis and treatment. A kidney biopsy requires an overnight hospital stay.

Your doctor may order a test for syphilis or anticardiolipin antibodies. A positive test does not mean that you have syphilis, but may indicate the presence of an antibody that increases the risk of blood clotting and miscarriages.

Treatments

There is currently no cure for lupus. However, for most people, effective treatment can greatly reduce symptoms and help maintain normal body functions. Treatment often includes:

  • Medications to reduce inflammation and activity of the immune system
  • Balancing rest with exercise
  • Maintaining a healthy diet

Drug Therapy

Medications commonly used to treat lupus, include:

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs) These drugs, such as aspirin and ibuprofen, may relieve muscle and joint pain as well as arthritis.
  • Acetaminophen This is the main ingredient in Tylenol, a mild pain reliever.
  • Corticosteroids Synthetically produced corticosteroids, such as Prednisone, are used to reduce inflammation and suppress activity of the immune system.
  • Antimalarials These drugs, such as Plaquenil, help with symptoms of lupus and also may prevent major flares in other organs.
  • Immunomodulating Drugs These drugs, such as Imuran, Cellcept, Methotrexate and Cytoxan, suppress the immune system. They may allow a reduction in the dose of corticosteroids.

Lifestyle Changes

For most people with lupus, making positive lifestyle changes allow them to better manage the disease and improve their quality of life. Preventive measures include:

  • Regular exercise that helps prevent muscle weakness and fatigue
  • Immunizations to protect against specific infections
  • Lifestyle adjustments, such as getting plenty of rest, reducing stress, eating a balanced diet and quitting smoking
  • Avoiding excessive sun exposure or regularly applying sunscreens in order to reduce rashes and flares in lupus

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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