Medications that suppress immunity (immunosuppressive medications) are also called cytotoxic drugs. They are sometimes referred to as chemotherapy because they are also used to treat cancer, generally in much higher doses than those used to treat lupus. Immunosuppressive medications are used for treating people with more severe manifestations of SLE, such as damage to internal organ(s). Examples of immunosuppressive medications include azathioprine (Imuran), cyclophosphamide (Cytoxan), chlorambucil (Leukeran), cyclosporine (Sandimmune), and the disease-modifying drug methotrexate (Rheumatrex, Trexall). All immunosuppressive medications can seriously depress blood-cell counts and increase risks of infection and bleeding. Immunosuppressive medications may not be taken during pregnancy or conceptionbecause of risk to the fetus. Other side effects are specific for each drug. For examples, methotrexate can cause liver toxicity, while cyclosporine can impair kidney function.

To unravel which people with positive ANA tests actually have lupus, additional blood work can be done. Doctors look for other potentially troublesome antibodies, so they will test for anti-double-stranded DNA and anti-Smith antibodies. These tests are less likely to be positive unless a patient truly has lupus. However, a person who has negative test results could still have lupus, even though this is not so in the case of ANA tests.

In patients with SLE, the risk of developing cardiovascular disease (CVD) is at least twice that in the general population, and over half of patients have 3 or more CVD risk factors.3,4 “Following a heart-healthy diet that is rich in fruits, vegetables, whole grains, lean protein, and fatty fish and limiting saturated and trans fats can actually help reduce the risk of heart disease,” Gibofsky told Rheumatology Advisor.
Describes a clinical trial in which two or more groups of participants receive different interventions. For example, a two-arm parallel design involves two groups of participants. One group receives drug A, and the other group receives drug B. So during the trial, participants in one group receive drug A “in parallel” to participants in the other group receiving drug B.
Inflammation of the lining of the lungs (pleuritis) with pain aggravated by deep breathing (pleurisy) and of the heart (pericarditis) can cause sharp chest pain. The chest pain is aggravated by coughing, deep breathing, and certain changes in body position. The heart muscle itself rarely can become inflamed (carditis). It has also been shown that young women with SLE have a significantly increased risk of heart attacks due to coronary artery disease.

SLE is undoubtedly a potentially serious illness with involvement of numerous organ systems. However, it is important to recognize that most people with SLE lead full, active, and healthy lives. Periodic increases in disease activity (flares) can usually be managed by varying medications. Since ultraviolet light can precipitate and worsen flares, people with systemic lupus should avoid sun exposure. Sunscreens and clothing covering the extremities can be helpful. Abruptly stopping medications, especially corticosteroids, can also cause flares and should be avoided. People with SLE are at increased risk of infections as SLE-related complications, especially if they are taking corticosteroids or immunosuppressive medications. Therefore, any unexpected fever should be reported to medical professionals and evaluated.
The epicenter of where inflammation begins is considered to be the microbiome. The human microbiome is a very complex ecosystem of trillions of bacteria that perform essential functions like absorbing nutrients, producing hormones, and defending us from microbes and environmental toxins. These bacteria are constantly in flux throughout our lives, adapting to the foods we eat, the quality of our sleep, the amount of bacteria or chemicals we’re exposed to on a daily basis, and the level of emotional stress we deal with.
Acute cutaneous: This is the type of skin flare that occurs when your SLE is active. Lesions associated with acute cutaneous lupus appear as flattened areas of red skin on the face, reminiscent of a sunburn—the telltale butterfly rash. These lesions can appear on the arms, legs, and body, and are photosensitive. Though the lesions may discolor the skin, they don't scar. Lesions typically appear during a flare or after sun exposure.

Erythrocyte Sedimentation Rate:  This is a blood test that is used to determine the rate at which red blood cells settle to the bottom of a tube in one hour’s time.  If the rate is faster than normal, it may be an indication of a systemic disease, like lupus.  It is important to note that this sedimentation rate, or rate of settling, does not specifically indicate lupus, but can be elevated if other inflammatory conditions are present like cancer or an infection.
Because the antibodies and accompanying cells of inflammation can affect tissues anywhere in the body, lupus has the potential to affect a variety of areas. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and/or nervous system. When only the skin is involved by rash, the condition is called lupus dermatitis or cutaneous lupus erythematosus. A form of lupus dermatitis that can be isolated to the skin, without internal disease, is called discoid lupus erythematosus. When internal organs are involved, the condition is referred to as systemic lupus erythematosus (SLE).
Pain is typically treated with opioids, varying in potency based on the severity of symptoms. When opioids are used for prolonged periods, drug tolerance, chemical dependency, and addiction may occur. Opiate addiction is not typically a concern since the condition is not likely to ever completely disappear. Thus, lifelong treatment with opioids is fairly common for chronic pain symptoms, accompanied by periodic titration that is typical of any long-term opioid regimen.
As an autoimmune disease that effects many different systems in the body, no food can cause lupus, this we know. What we know for certain, is that  the foods that you eat and the medications you take, can have an effect on the severity of symptoms, as well as the frequency of lupus flares. Some of the most important issues that specifically relate to lupus patients, with regards to diet and nutrition are;
Blood—hematologic disorder—hemolytic anemia (low red blood cell count), leukopenia (white blood cell count<4000/µl), lymphopenia (<1500/µl), or low platelet count (<100000/µl) in the absence of offending drug; sensitivity = 59%; specificity = 89%.[75] Hypocomplementemia is also seen, due to either consumption of C3[76] and C4 by immune complex-induced inflammation or to congenitally complement deficiency, which may predispose to SLE.

There are over 200 disorders that impact connective tissue. Some, like cellulitis, are the result of an infection. Injuries can cause connective tissue disorders, such as scars. Others, such as Ehlers-Danlos syndrome, Marfan syndrome, and osteogenesis imperfecta, are genetic. Still others, like scleroderma, have no known cause. Each disorder has its own symptoms and needs different treatment.


Genetics Doctors and researchers believe a genetic predisposition may contribute to the development of lupus, says Kaplan. Dozens of genetic variations have been found to be associated with the disease, affecting who gets it and how severe those cases are, according to the Lupus Foundation of America. That means the disease is hereditary, making parents more likely to pass it to their children. But just because you are genetically predisposed to the condition, doesn’t necessarily mean you’ll get it.
Useful medication for the disease was first found in 1894, when quinine was first reported as an effective therapy. Four years later, the use of salicylates in conjunction with quinine was noted to be of still greater benefit. This was the best available treatment until the middle of the twentieth century, when Hench discovered the efficacy of corticosteroids in the treatment of SLE.[121]
Systemic lupus erythematosus (SLE) is a complex multisystemic autoimmune disease resulting, oftentimes, in irreversible damage, diminished quality of life and reduced life expectancy.1–3 Genetic and environmental factors play important roles in its pathogenesis.4–8 Disease manifestations and severity vary according to the patients’ racial/ethnic background and socioeconomic status (SES).1 9 10 Data from Grupo Latino Americano de Estudio del Lupus (GLADEL), Lupus in Minorities: Nature vs Nurture (LUMINA) and the Lupus Family Registry and Repository cohorts have demonstrated that Latin American and North American Mestizo patients (mixed Amerindian and European ancestry), African descendants and Native Americans develop lupus earlier11 12 although diagnostic delays may occur.1 They also experience more severe disease, have higher disease activity levels,1 accrue more organ damage2 and have higher mortality rates,1 succumbing mainly to disease activity and/or infections.1 3 13–15
Drugs used to treat lupus include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, alone or combined with other drugs for pain, swelling, and fever. Drugs that work inside cells, including antimalarial drugs such as hydroxychloroquine (Plaquenil) are used for fatigue, joint pain, skin rashes, and inflammation of the lungs. Continuous treatment with antimalarials may prevent lupus flare up from recurring.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Moderate use of alcohol is usually not a problem for people with lupus, but alcohol can lower the effectiveness of some medications, cause new health problems, and/or can make existing problems worse. For example, non-steroidal anti-inflammatory drugs -- such as aspirin, ibuprofen (Motrin®), naproxen (Naprosyn®), and celecoxib (Celebrex®) -- can cause ulcers and bleeding in the stomach and intestines at any time during treatment; the chance of developing an ulcer or internal bleeding increases with alcohol use. Also, anticoagulant medicines such as warfarin (Coumadin®) and the chemotherapy drug, methotrexate, may not be as effective if you are drinking alcohol.
A healthy diet is important in general, but perhaps even more so for the roughly 1 million Americans and 3 million people worldwide who suffer from systemic lupus erythematosus (SLE).1 Because of the multifaceted challenges presented by the disease, consuming adequate amounts of the right nutrients — and limiting others — can help relieve symptoms and improve outcomes.
Flare-ups of lupus can cause acute inflammation and damage to various body tissues and can affect the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Some of the most common symptoms are painful or swollen joints, unexplained fever, kidney problems and extreme fatigue. A characteristic red skin rash – called a “malar” or “butterfly” rash because it roughly mimics the insect’s shape – may appear across the nose and cheeks. Rashes may also occur on the face and ears, upper arms, shoulders, chest, and hands. Because many lupus patients are sensitive to sunlight, skin rashes often develop or worsen after sun exposure.
Lupus can affect men and women of any race or age. One in 2,000 people in the United States has lupus. People of African, Asian and Native American descent are more likely to develop lupus than are Caucasians. In addition, the disease develops in Emiratis at an earlier stage compared to Asians and expatriate Arabs working in UEA. Lupus studies also show racial preferences, being more prevalent among Arabs than Asians in the UAE region.
The cause of SLE is not clear.[1] It is thought to involve genetics together with environmental factors.[4] Among identical twins, if one is affected there is a 24% chance the other one will be as well.[1] Female sex hormones, sunlight, smoking, vitamin D deficiency, and certain infections, are also believed to increase the risk.[4] The mechanism involves an immune response by autoantibodies against a person's own tissues.[1] These are most commonly anti-nuclear antibodies and they result in inflammation.[1] Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests.[1] There are a number of other kinds of lupus erythematosus including discoid lupus erythematosus, neonatal lupus, and subacute cutaneous lupus erythematosus.[1]
The loss of self-tolerance is believed to be due to many hereditary and environmental factors and occurs when autoantigens are damaged, when they link with a foreign antigen, when the structure of a autoantigen is very similar to that of a foreign antigen (molecular mimicry), or when autoreactive T cells are not adequately controlled or are activated by nonspecific antigens. The changes in the appearance of the autoantigen or activation of autoreactive T-cells result in autoantigens being perceived as foreign. Inflammation and destruction of the tissues bearing the antigen occur because of the production of autoantibodies by B cells or the cytotoxicity of autoreactive T cells, which attack the autoantigens.
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There have also been case reports of patients with severe refractory SLE in which off-label use of rituximab showed benefits with tolerable safety profiles. [120, 121, 122] For example, in a retrospective study of 115 patients with severe or refractory SLE, 40% of patients had a complete response and 27% had a partial response, as measured by BILAG scores recorded 6 months after the first rituximab treatment. [123]


ANA = antinuclear antibody; CNS = central nervous system; ds-DNA = double-stranded DNA; ELISA = enzyme-linked immunoassay; ENA = extractable nuclear antigen; Ig = immunoglobulin; p-ANCA = perinuclear antineutrophil cytoplasmic antibody; RBCs = red blood cells; RNP = ribonucleic protein; SLE = systemic lupus erythematosus; Sm = Smith; SSA = Sjögren syndrome A; SSB = Sjögren syndrome B.
Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis, and autoimmune thyroid disorders are more common among relatives of people with lupus than the general population. Moreover, it is possible to have more than one autoimmune disease in the same individual. Therefore, "overlap" syndromes of lupus and rheumatoid arthritis, or lupus and scleroderma, etc., can occur.
I believe that we should ALL benefit from regularly working on stress relief! Take care of yourself by adopting stress-relieving strategies, such as exercise, meditation, yoga, art, or whatever works for you. The key is to choose something that you will enjoy and stick with. I personally use a heart rhythm pacer called InnerBalance, an app that coaches you to breathe in line with your heartbeat. Even giving yourself five minutes to sit quietly with a fragrant cup of herbal tea (caffeine-free, of course!) can work wonders for your adrenal glands.
In its simplest definition, the CBC is used to measure red and white blood cell count, the total amount of hemoglobin in the blood, hematocrit (the amount of blood composed of red blood cells), and mean corpuscular volume (the size of red blood cells). The CBC can also count additional blood cell types like neutrophils, eosinophils, basophils, lymphocytes, monocytes, and platelets.
Lupus antibodies can be transferred from the mother to the fetus and result in lupus illness in the newborn ("neonatal lupus"). This includes the development of low red cell counts (hemolytic anemia) and/or white blood cell counts (leucopenia) and platelet counts (thrombocytopenia) and skin rash. Problems can also develop in the electrical system of the baby's heart (congenital heart block). Occasionally, a pacemaker for the baby's heart is needed in this setting. Neonatal lupus and congenital heart block are more common in newborns of mothers with SLE who carry specific antibodies referred to as anti-Ro (or anti-SSA) and anti-La (or anti-SSB). (It is helpful for the newborn baby's doctor to be made aware if the mother is known to carry these antibodies, even prior to delivery. The risk of heart block is 2%; the risk of neonatal lupus is 5%.) Neonatal lupus usually clears after 6 months of age, as the mother's antibodies are slowly metabolized by the baby.
Lupus Erythematosus is a chronic autoimmune disease that causes the immune system to attack one’s body. The disease is characterized by the inflammation of various healthy tissues and organs in the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. The severity of the disease may vary because no two cases of lupus are exactly alike.
Lupus is a chronic autoimmune condition in which the immune system attacks the body’s own healthy tissue and organs. Depending on the specific patient, lupus can cause high levels of persistent inflammation that can negatively affect various parts of the body. Lupus patients often experience tissue damage that affects the heart, joints, brain, kidneys, lungs and endocrine glands (such as the adrenals and thyroid gland). Although it’s not completely known why this happens, lupus risk factors are believed to include: (2)
Lupus is chronic, complex, and difficult to diagnose. No single lab test can tell if you have lupus. Many lupus symptoms imitate symptoms of other diseases and often come and go. Your primary care doctor or rheumatologist will use your medical history, a physical exam, and many routine as well as special tests to rule out other diseases. Many physicians also use the American College of Rheumatology's "Eleven Criteria of Lupus" to aid in the diagnosis of lupus. The criteria include symptoms as well as specific laboratory findings that provide information about the functioning of a person's immune system. In most cases, the diagnosis of lupus is made when four or more of the criteria have occurred at some time.
CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can’t get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts’ blood supply, causing permanent heart damage.
Lupus is diagnosed when a person has several features of the disease (including symptoms, findings on examination, and blood test abnormalities). The American College of Rheumatology has devised criteria to assist doctors in making the correct diagnosis of lupus. A person should have at least four of the following 11 criteria, either at the same time or one after the other, to be classified as having lupus. These criteria include:

Studies from around the world have documented a higher prevalence of vitamin D insufficiency and deficiency in patients with SLE, compared with the general population, especially in conjunction with obesity. [108, 152, 153, 154, 155, 110] Studies from Australia, [152] France, [155] the Mediterranean region, [109] and Taiwan [154] —but not from Mexico [153] —have shown an association between serum vitamin D levels and SLE disease activity.


As you've possibly experienced, your doctor is not going to provide you with a healing regime so you must find your way to learning how to work with your body in a healing crisis. There are many, many answers that will support you in reducing your lupus symptoms, even reversing them altogether. Your diet for lupus should be the first line of defense.
Jump up ^ Henderson, LA; Loring, SH; Gill, RR; Liao, KP; Ishizawar, R; Kim, S; Perlmutter-Goldenson, R; Rothman, D; Son, MB; Stoll, ML; Zemel, LS; Sandborg, C; Dellaripa, PF; Nigrovic, PA (March 2013). "Shrinking lung syndrome as a manifestation of pleuritis: a new model based on pulmonary physiological studies". The Journal of Rheumatology. 40 (3): 273–81. doi:10.3899/jrheum.121048. PMC 4112073. PMID 23378468.
Management of systemic lupus erythematosus (SLE) often depends on disease severity and disease manifestations, [8] although hydroxychloroquine has a central role for long-term treatment in all SLE patients. The LUMINA (Lupus in Minorities: Nature versus Nurture) study and other trials have offered evidence of a decrease in flares and prolonged life in patients given hydroxychloroquine, making it the cornerstone of SLE management. [104]

Inflammation of the heart muscle, usually in the U.S. as a consequence of infections (viruses, esp. coxsackie virus, and occasionally as a consequence of bacterial, protozoan or fungal infections); immunological-rheumatological conditions (e.g., systemic lupus erythematosus, ulcerative colitis, hypersensitivity reactions, or transplant rejection); exposure to chemicals or toxins (e.g., cocaine, doxorubicin, methamphetamine); nutritional or metabolic abnormalities (e.g., thiamine deficiency or hypophosphatemia); or radiation. Myocarditis also is occasionally found in pregnancy and with advanced age. The myocardium is infiltrated by leukocytyes, lymphocytes, and macrophages, leading to inflammation, necrosis of muscle cells, and fibrosis. Inflammatory damage to heart muscle fibers may resolve spontaneously or may cause progressive deterioration of the heart with pericarditis, arrhythmias, chronic dilated cardiomyopathy, and heart failure.

Hydroxychloroquine (Plaquenil) is an antimalarial medication found to be particularly effective for SLE people with fatigue, skin involvement, and joint disease. Consistently taking Plaquenil can prevent flare-ups of lupus. Side effects are uncommon but include diarrhea, upset stomach, and eye-pigment changes. Eye-pigment changes are rare but require monitoring by an ophthalmologist (eye specialist) during treatment with Plaquenil. Researchers have found that Plaquenil significantly decreased the frequency of abnormal blood clots in people with systemic lupus. Moreover, the effect seemed independent of immune suppression, implying that Plaquenil can directly act to prevent the blood clots. This fascinating study highlights an important reason for people and doctors to consider Plaquenil for long-term use, especially for those SLE people who are at some risk for blood clots in veins and arteries, such as those with phospholipid antibodies (cardiolipin antibodies, lupus anticoagulant, and false-positive venereal disease research laboratory test). This means not only that Plaquenil reduces the chance for re-flares of SLE, but it can also be beneficial in thinning the blood to prevent abnormal excessive blood clotting. Plaquenil is commonly used in combination with other treatments for lupus.
Cognitive impairment is defined as any difficulty with normal thought functions or processes, such as thinking, learning, or remembering. Cognitive impairment can occur as a neurological symptom of lupus. However, cognitive impairment is a common occurrence that happens to everyone at some time, not just lupus patients, and it can affect one single thought process or many thought processes either temporarily or permanently.

Inflammation of the pleurae known as pleurisy can rarely give rise to shrinking lung syndrome.[25] SLE can cause pleuritic pain and also give rise to shrinking lung syndrome, involving a reduced lung volume.[26] Other associated lung conditions include pneumonitis, chronic diffuse interstitial lung disease, pulmonary hypertension, pulmonary emboli, and pulmonary hemorrhage.


As someone who has healed Lupus, I often get asked about the importance of diet. Several years ago I was diagnosed with lupus. I could barely get out of bed or walk, had a hard time holding a glass of juice due to joint pain, suffered from all over body muscle aches, endured a constant low grade fever, and itched uncontrollably on my arms with skin rash. I new my life, as I new it, was over. I was petrified.

Neutrophils, 55% to 70% of all leukocytes, are the most numerous phagocytic cells and are a primary effector cell in inflammation. Eosinophils, 1% to 3% of total leukocytes, destroy parasites and are involved in allergic reactions. Basophils, less than 1% of all leukocytes, contain granules of histamine and heparin and are part of the inflammatory response to injury. Monocytes, 3% to 8% of all leukocytes, become macrophages and phagocytize pathogens and damaged cells, esp. in the tissue fluid. Lymphocytes, 20% to 35% of all leukocytes, have several functions: recognizing foreign antigens, producing antibodies, suppressing the immune response to prevent excess tissue damage, and becoming memory cells.


Fad-diets can be tempting as they offer a quick-fix to a long-term problem. However, they can risk your health. You should follow advice from a doctor or dietician when seeking to change diet. The best way to lose weight and keep it off is to make healthier choices, eat a nutritionally balanced and varied diet with appropriately sized portions, and be physically active. For advice on exercising with lupus, you can read our article HERE.
Synovitis is an inflammation of the joint lining, called synovium. The symptoms are often of short duration and may change location although when caused by overuse tend to remain in one joint. The pain is usually more severe than expected based on the appearance of the joint on examination. In fact, sometimes there is pain without swelling or even tenderness in the joint, in which case the symptom is called “arthralgias” (literally meaning “joint pain” in Greek). Although synovitis has many different causes, the most common cause in an active healthy person is overuse.
García-Carrasco M1, Mendoza-Pinto C, Cardiel MH, Méndez-Martínez S, García-Villaseñor A, Jiménez-Hernández C, Alonso-García NE, Briones-Rojas R, Ramos-Álvarez G, López-Colombo A. "Health related quality of life in Mexican women with systemic lupus erythematosus: a descriptive study using SF-36 and LupusQoL(C)." Lupus 21.11 Oct. 2012. .

The immune system must balance between being sensitive enough to protect against infection, and become sensitized to attack the body's own proteins (autoimmunity). During an immune reaction to a foreign stimulus, such as bacteria, virus, or allergen, immune cells that would normally be deactivated due to their affinity for self-tissues can be abnormally activated by signaling sequences of antigen-presenting cells. Thus triggers may include viruses, bacteria, allergens (IgE and other hypersensitivity), and can be aggravated by environmental stimulants such as ultraviolet light and certain drug reactions. These stimuli begin a reaction that leads to destruction of other cells in the body and exposure of their DNA, histones, and other proteins, particularly parts of the cell nucleus. The body's sensitized B-lymphocyte cells will now produce antibodies against these nuclear-related proteins. These antibodies clump into antibody-protein complexes which stick to surfaces and damage blood vessels in critical areas of the body, such as the glomeruli of the kidney; these antibody attacks are the cause of SLE. Researchers are now identifying the individual genes, the proteins they produce, and their role in the immune system. Each protein is a link on the autoimmune chain, and researchers are trying to find drugs to break each of those links.[10][56][57]

The symptoms involved in CREST syndrome are associated with the generalized form of the disease Systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. The “C” stands for calcinosis, where calcium deposits form under the skin on the fingers or other areas of the body. The “R”, stands for Raynaud’s phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The “E” represents esophageal dysmotility, which can cause difficulty in swallowing. The “S” is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter “T” is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth.


Corticosteroids and immune suppressants: Patients with serious or life-threatening problems such as kidney inflammation, lung or heart involvement, and central nervous system symptoms need more “aggressive” (stronger) treatment. This may include high-dose corticosteroids such as prednisone (Deltasone and others) and drugs that suppress the immune system. Immune suppressants include azathioprine (Imuran), cyclophosphamide (Cytoxan), and cyclosporine (Neoral, Sandimmune). Recently mycophenolate mofetil has been used to treat severe kidney disease in lupus – referred to as lupus nephritis.

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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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