No diet-based treatment of SLE has been proven effective. Patients with SLE should be reminded that activity may need to be modified as tolerated. Specifically, stress and physical illness may precipitate SLE flares. Additionally, persons with SLE should wear sunscreen and protective clothing or avoid sun exposure to limit photosensitive rash or disease flares.
Micrograph of a section of human skin prepared for direct immunofluorescence using an anti-IgG antibody. The skin is from a person with systemic lupus erythematosus and shows IgG deposits at two different places. The first is a bandlike deposit along the epidermal basement membrane ("lupus band test" is positive); the second is within the nuclei of the epidermal cells (antinuclear antibodies are present).
Numerous studies suggest that moderate intake of alcohol may decrease the risks of developing cardiovascular disease problems, increase HDL good cholesterol levels, and may even decrease the risk for certain cancers. However, the sugar it contains will increase your calorie consumption (potentially contributing to weight gain) and regular alcohol consumption may increase the risk for breast cancer.
One food for people with lupus to avoid is alfalfa. Alfalfa tablets have been associated with reports of a lupus-like syndrome or lupus flares. The lupus-like effects may include muscle pain, fatigue, abnormal blood test results, changes in how the immune system functions, and kidney problems. These reactions may be due to the amino acid L-canavanine (found in alfalfa seeds and sprouts, but not in leaves), which can activate the immune system and increase inflammation.
Sometimes changes in blood counts may contribute to symptoms of fatigue (low red blood cell count, anemia), serious infections (low white blood cell count), or easy bruising (low platelet count). However, many patients do not have symptoms that indicate blood abnormalities, so it is important for lupus patients to have periodic blood tests in order to detect any problems.
Dermatomyositis (DM) and polymyositis (PM): While almost all people with lupus have a positive ANA test, only around 30 percent of people with DM and PM do. Many of the physical symptoms are different as well. For instance, people with DM and PM don't have the mouth ulcers, kidney inflammation, arthritis, and blood abnormalities that people with lupus do.
Antinuclear antibody (ANA) testing and anti-extractable nuclear antigen (anti-ENA) form the mainstay of serologic testing for SLE. Several techniques are used to detect ANAs. Clinically the most widely used method is indirect immunofluorescence (IF). The pattern of fluorescence suggests the type of antibody present in the people's serum. Direct immunofluorescence can detect deposits of immunoglobulins and complement proteins in the people's skin. When skin not exposed to the sun is tested, a positive direct IF (the so-called lupus band test) is an evidence of systemic lupus erythematosus.
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.
Kidney involvement in people with lupus is potentially life threatening and may occur in up to half of lupus patients. Kidney problems may become apparent when lupus patients feel ill with arthritis, have a rash, fever and weight loss. Less often, kidney disease may occur when there are no other symptoms of lupus. Kidney disease itself usually does not produce symptoms until it is in the advanced stages. It is important that kidney disease be diagnosed early and treated appropriately. The earliest signs of kidney disease are apparent from a urinalysis.
The term undifferentiated connective tissue diseases is used to define conditions characterized by the presence of signs and symptoms suggestive of a systemic autoimmune disease that do not satisfy the classificative criteria for defined connective tissue diseases (CTD) such as systemic lupus erythematosus (SLE), Sjögren’s syndrome (SS), rheumatoid arthritis (RA) and others. A small percentage of patients presenting with an undifferentiated profile will develop during the first year follow up of a full blown CTD, however an average of 75% will maintain an undifferentiated clinical course. These patients may be defined as having a stable undifferentiated connective tissue diseases (UCTD). The most characteristic symptoms of UCTD are represented by arthritis and arthralgias, Raynaud’s phenomenon, leukopenia, while neurological and kidney involvement are virtually absent. Eighty percent of these patients have a single autoantibody specificity, more frequently anti-Ro and anti-RNP antibodies. Stable UCTD are considered as distinct clinical entities and therefore it has been proposed to define those conditions as UCTD. Classificative criteria have also been proposed and a work to better define them is still under way.
Competing interests LBF, BAPE and OAM have been speakers for GlaxoSmithKline (GSK). JCTB has received research grants from GSK. RMX, ON and JFM have received support grants for meetings from GSK. JAGP has been a lecturer for Roche. ERS has received research grants and has been a lecturer for Roche. JFM has been a clinical researcher for Anthera. MHC has received research grants from Roche and is an advisor for Eli Lilly.
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.
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.
With the vast amount of misinformation available online, Gibofsky often sees patients who went on restrictive diets that are purported to reduce lupus symptoms, which they may have read about on the internet or heard about from a neighbor. “Upon further discussion, I find that they do not actually feel better on the diet and, in fact, they have multiple nutritional deficiencies that could actually be the reason behind their worsening symptoms,” she said.
If you have difficulty with certain tasks in the kitchen due to stiffness, pain or weakness, there is a wide range of special equipment available that can make things easier. You can find details about many of these products for homes and kitchens HERE. You may wish to discuss the possibility of being referred to your rheumatology clinic’s occupational therapy team so that you can have your individual needs assessed.
Painless passage of blood or protein in the urine may often be the only presenting sign of kidney involvement. Acute or chronic renal impairment may develop with lupus nephritis, leading to acute or end-stage kidney failure. Because of early recognition and management of SLE, end-stage renal failure occurs in less than 5% of cases; except in the black population, where the risk is many times higher.
How an autoimmune disease affects you depends on what part of the body is targeted. If the disease affects the joints, as in rheumatoid arthritis, you might have joint pain, stiffness, and loss of function. If it affects the thyroid, as in Graves’ disease and thyroiditis, it might cause tiredness, weight gain, and muscle aches. If it attacks the skin, as it does in scleroderma/systemic sclerosis, vitiligo, and systemic lupus erythematosus (SLE), it can cause rashes, blisters, and color changes.
Many people living with lupus are photosensitive or sensitive to the sun and fluorescent lights. It is recommended that all people living with lupus wear sunscreen. Sunscreens, greater than SPF 30, are vital in protecting patients from UVA and UVB rays which provoke skin rashes, lesions and other lupus disease activity. Patients should also avoid excess sun exposure by wearing sunscreen, wide-brim hats, avoid sunlight during peak hours of UV exposure (10:00 am - 2:00 pm) and wear tightly woven clothing.
Peer review is the first stage of our grant decision-making process. All applications received are reviewed by top experts in the field, to determine whether or not those studies show great promise. After all, we only want to scrutinize the best projects most carefully. This crucial first step allows only the projects that have tremendous scientific merit and hold great promise for preventing, treating, and curing lupus, to advance to the second stage of the review process. That second stage is a process managed by our Scientific Advisory Board, where they take all of the top scoring applications, scrutinize them very carefully, and then make recommendations to our Board of Directors, for which ones we are actually going to fund.
Changes in ESR over time can help guide a healthcare professional toward a possible diagnosis. Moderately elevated ESR occurs with inflammation, but also with anemia, infection, pregnancy, and old age. A very high ESR usually has an obvious cause, such as a marked increase in globulins that can be due to a severe infection. A rising ESR can mean an increase in inflammation or a poor response to a therapy. A decreasing ESR can mean a good response, though keep in mind that a low ESR can be indicative of diseases such as polycythemia, extreme leukocytosis, and protein abnormalities.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), may be used to treat pain, swelling and fever associated with lupus. Stronger NSAIDs are available by prescription. Side effects of NSAIDs include stomach bleeding, kidney problems and an increased risk of heart problems.
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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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