Monocytes isolated from whole blood of people with SLE show reduced expression of CD44 surface molecules involved in the uptake of apoptotic cells. Most of the monocytes and tingible body macrophages (TBMs), which are found in the germinal centres of lymph nodes, even show a definitely different morphology; they are smaller or scarce and die earlier. Serum components like complement factors, CRP, and some glycoproteins are, furthermore, decisively important for an efficiently operating phagocytosis. With SLE, these components are often missing, diminished, or inefficient.
In 2009, an American College of Rheumatology (ACR) Task Force generated a quality indicator set. [107] In 2012, the ACR published “ Guidelines for the Screening, Diagnosis, Treatment and Monitoring of Lupus Nephritis in Adults,” as well as an evidence report for lupus nephritis. These and other guidelines are available at the ACR's Clinical Practice Guidelines Web site.

Systemic lupus erythematosus is a multisystem inflammatory disease that is often difficult to diagnose. Before the diagnosis can be established, four of 11 clinical and laboratory criteria must be met. Antinuclear antibody titer is the primary laboratory test used to diagnose systemic lupus erythematosus. Because of the low prevalence of the disease in primary care populations, the antinuclear antibody titer has a low predictive value in patients without typical clinical symptoms. Therefore, as specified by the American College of Rheumatology, this titer should be obtained only in patients with unexplained involvement of two or more organ systems. Pa tients with an antinuclear antibody titer of 1:40 and characteristic multiorgan system involvement can be diagnosed with systemic lupus erythematosus without additional testing; however, patients with an antibody titer of 1:40 who fail to meet full clinical criteria should undergo additional testing, including tests for antibody to doublestranded DNA antigen and antibody to Sm nuclear antigen. While an antinuclear antibody titer of less than 1:40 usually rules out systemic lupus erythematosus, patients with persistent, characteristic multisystem involvement may be evaluated for possible antinuclear antibody–negative disease.
Heart and Lungs. Heart and lung involvement often is caused by inflammation of the covering of the heart (pericardium) and lungs (pleura). When these structures become inflamed, patients may develop chest pain, irregular heartbeat, and accumulation of fluid around the lungs (pleuritis or pleurisy) and heart (pericarditis). The heart valves and the lung itself can also be affected by lupus, resulting in shortness of breath.
  According to the Mayo Clinic, “People with lupus should eat plenty of fruits, vegetables and whole grains. These foods are rich in vitamins, minerals and essential nutrients that benefit overall health and can help prevent high blood pressure, heart disease, kidney disease, cancer and digestive disorders. Plant-based diets also support a healthy weight because they are naturally low in calories, fat and cholesterol. Fruits and vegetables are particularly high in antioxidants. Antioxidants protect the body by destroying harmful substances that damage cells and tissue and cause heart disease and cancer.” Take a look at our blog, Lupus: the Diet Dilemma for some great tips. While these diets, or eating plans, may have some merit, individual foods should not be the focus. Pay attention to your overall pattern of nutrition. Reducing inflammation is not just about what you eat.  Patients should also know that these diets are never meant to be a replacement for the lupus treatments they may already be taking under the close supervision of a medical professional. Until more research is in on the effectiveness of these diets, be practical by getting enough sleep and exercise, and try to maintain a healthy weight. Back to top
Lupus is treated by internal medicine subspecialists called rheumatologists. Depending on whether or not specific organs are targeted, other health specialists who can be involved in the care of patients with lupus include dermatologists, nephrologists, hematologists, cardiologists, pulmonologists, and neurologists. It's not uncommon that a team of such physicians is coordinated by the treating rheumatologist together with the primary care doctor.
SLE is associated with defects in apoptotic clearance, and the damaging effects caused by apoptotic debris. Early apoptotic cells express “eat-me” signals, of cell-surface proteins such as phosphatidylserine, that prompt immune cells to engulf them. Apoptotic cells also express “find-me” signals, to attract macrophages and dendritic cells. When apoptotic material is not removed correctly by phagocytes, they are captured instead by antigen-presenting cells, which leads to development of antinuclear antibodies.[4]
*All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at info@kflupus.org for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus. **All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your medical provider with any specific questions or concerns.    

Electrolytes are minerals in your body that have an electric charge. They are in your blood, urine and body fluids. Maintaining the right balance of electrolytes helps your body’s blood chemistry, muscle action and other processes. Sodium, calcium, potassium, chlorine, phosphate and magnesium are all electrolytes. You get them from the foods you eat and the fluids you drink.

Rate of SLE varies between countries from 20 to 70 per 100,000.[2] Women of childbearing age are affected about nine times more often than men.[4] While it most commonly begins between the ages of 15 and 45, a wide range of ages can be affected.[1][2] Those of African, Caribbean, and Chinese descent are at higher risk than white people.[4][2] Rates of disease in the developing world are unclear.[6] Lupus is Latin for "wolf": the disease was so-named in the 13th century as the rash was thought to appear like a wolf's bite.[7]


Granulocytes and monocytes, collectively called myeloid cells, are differentiated descendants from common progenitors derived from hematopoietic stem cells in the bone marrow. Commitment to either lineage of myeloid cells is controlled by distinct transcription factors followed by terminal differentiation in response to specific colony-stimulating factors and release into the circulation. Upon pathogen invasion, myeloid cells are rapidly recruited into local tissues via various chemokine receptors, where they are activated for phagocytosis as well as secretion of inflammatory cytokines, thereby playing major roles in innate immunity.
Autoreactive B cells can accidentally emerge during somatic hypermutation and migrate into the germinal center light zone. Autoreactive B cells, maturated coincidentally, normally do not receive survival signals by antigen planted on follicular dendritic cells and perish by apoptosis. In the case of clearance deficiency, apoptotic nuclear debris accumulates in the light zone of GC and gets attached to FDC. This serves as a germinal centre survival signal for autoreactive B-cells. After migration into the mantle zone, autoreactive B cells require further survival signals from autoreactive helper T cells, which promote the maturation of autoantibody-producing plasma cells and B memory cells. In the presence of autoreactive T cells, a chronic autoimmune disease may be the consequence.
The most commonly sought medical attention is for joint pain, with the small joints of the hand and wrist usually affected, although all joints are at risk. More than 90 percent of those affected will experience joint or muscle pain at some time during the course of their illness.[16] Unlike rheumatoid arthritis, lupus arthritis is less disabling and usually does not cause severe destruction of the joints. Fewer than ten percent of people with lupus arthritis will develop deformities of the hands and feet.[16] People with SLE are at particular risk of developing osteoarticular tuberculosis.[17]
Photosensitive systemic lupus erythematosus (SLE) rashes typically occur on the face or extremities, which are sun-exposed regions. Although the interphalangeal spaces are affected, the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are spared. Photo courtesy of Dr. Erik Stratman, Marshfield Clinic.

While SLE can occur in both males and females, it is found far more often in women, and the symptoms associated with each sex are different.[5] Females tend to have a greater number of relapses, a low white blood cell count, more arthritis, Raynaud's phenomenon, and psychiatric symptoms. Males tend to have more seizures, kidney disease, serositis (inflammation of tissues lining the lungs and heart), skin problems, and peripheral neuropathy.[12]
With variants known as discoid lupus, subacute cutaneous lupus, and systemic lupus erythematosus, lupus is one of several disorders of the immune system considered “autoimmune” in nature. These diseases occur when the immune system malfunctions and turns its infection-defense capabilities against the body, producing antibodies against healthy cells and tissues. These antibodies promote chronic inflammation and can damage organs and tissues. In lupus, these antibodies are known as antinuclear antibodies (ANA) because they target parts of the cell’s nucleus. Experts don’t yet fully understand all of the factors and triggers that cause inflammation and tissue damage in lupus, and research is ongoing.
Levels of stress-related illnesses are on the rise, and stress, both emotional and physical, has been shown to trigger and intensify autoimmune disorders. Stress is your body’s response to a threat–a wound, injury, or infection. Acute stress revs up your immune system to help you deal with an immediate crisis, and then calms it back down once the threat is removed. On the other hand, chronic stress (the kind we face in this day and age) leads to long-term inflammation and actually suppresses your immune system. This can trigger or worsen autoimmune conditions, and can lead to the reactivation of latent viruses linked to lupus, perpetuating a vicious cycle.
As many as 70% of people with lupus have some skin symptoms. The three main categories of lesions are chronic cutaneous (discoid) lupus, subacute cutaneous lupus, and acute cutaneous lupus. People with discoid lupus may exhibit thick, red scaly patches on the skin. Similarly, subacute cutaneous lupus manifests as red, scaly patches of skin but with distinct edges. Acute cutaneous lupus manifests as a rash. Some have the classic malar rash (or butterfly rash) associated with the disease.[13] This rash occurs in 30 to 60% of people with SLE.[14]

While there are no hard and fast rules when it comes to designing a lupus diet for yourself, try to include a wide-range of foods that contain antioxidants and fatty acids. Make sure you get enough iron and vitamins, especially vitamins C and D. Use coffee and tea in moderation. Avoid highly processed and preserved foods, and keep track of foods that seem to trigger your lupus symptoms.


Analgesics, or pain relievers, are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.
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.
In 2009, an American College of Rheumatology (ACR) Task Force generated a quality indicator set. [107] In 2012, the ACR published “ Guidelines for the Screening, Diagnosis, Treatment and Monitoring of Lupus Nephritis in Adults,” as well as an evidence report for lupus nephritis. These and other guidelines are available at the ACR's Clinical Practice Guidelines Web site.

*All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at info@kflupus.org for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus. **All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your medical provider with any specific questions or concerns.
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.
A randomized, double-blind, placebo-controlled trial in 40 patients with juvenile-onset SLE suggests that cholecalciferol supplementation for 24 weeks is effective in decreasing disease activity and improving fatigue in these patients. Compared with the placebo group, patients receiving oral cholecalciferol 50,000 IU/week demonstrated significant improvement in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores (P = 0.010) and European Consensus Lupus Activity Measurement (ECLAM) scores (P = 0.006), along with a reduction of fatigue related to social life, as measured by the Kids Fatigue Severity Scale (K-FSS) score (P = 0.008). [110]
16α-OH 16α-hydroxyestrone; 2-OH 2-hydroxyestrone; Akt protein kinase B; BAFF B-cell activating factor; EGCG epigallocatechin gallate; ER oestrogen receptor; EVOO extra virgin olive oil; FOXP3 forkhead box P3; I3C indole-3-carbinol; IFN interferon; LPS lipopolysaccharide; MRL Murphy Roths large; NZB/W New Zealand black/white; Nrf-2 nuclear factor E2-related factor 2; SLE systemic lupus erythematosus; Th T-helper; Treg regulatory T-cell; dsDNA double-stranded DNA; ppm parts per million; Diet; Immunomodulation; Lupus; Nutrients; Systemic lupus erythematosus

Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body.[1] Symptoms vary between people and may be mild to severe.[1] Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face.[1] Often there are periods of illness, called flares, and periods of remission during which there are few symptoms.[1]
Your kidneys are two bean-shaped organs, each about the size of your fists. They are located near the middle of your back, just below the rib cage. Inside each kidney about a million tiny structures called nephrons filter blood. They remove waste products and extra water, which become urine. The urine flows through tubes called ureters to your bladder, which stores the urine until you go to the bathroom. Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems, injuries, or medicines.

The removal of plasma from a patient (usually to treat an immmunologically mediated illness such as thrombotic thrombocytopenic purpura or myasthenia gravis) and its replacement with normal plasma. Plasma exchange therapy can also be used to replace excessively viscous plasma in patients with Waldenström macroglobulinemia. Pathological antibodies, immune complexes, and protein-bound toxins are removed from the plasma by plasma exchange. Immunoglobulin infusions are an alternative to plasma exchange when treating some immunological illnesses, including Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.
Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You also have at least four of these other symptoms:
In more severe cases, medications that modulate the immune system (primarily corticosteroids and immunosuppressants) are used to control the disease and prevent recurrence of symptoms (known as flares). Depending on the dosage, people who require steroids may develop Cushing's syndrome, symptoms of which may include obesity, puffy round face, diabetes mellitus, increased appetite, difficulty sleeping and osteoporosis. These may subside if and when the large initial dosage is reduced, but long-term use of even low doses can cause elevated blood pressure and cataracts.
Toll-like receptors (TLRs) are an essential arm of the innate immune response to bacteria, viruses and fungi and link recognition of distinct features of these microbes to the induction of pro-inflammatory signaling pathways. These receptors are able to respond to broad classes of pathogens because each TLR recognizes specific conserved microbial features.
Neonatal lupus erythematosus (NLE) can develop in the babies of mothers with antibodies to SSA/Ro. Neonates with NLE can present with rash around 4-6 weeks of life, elevated liver function test results, thrombocytopenia around 1-2 weeks of life, neutropenia, and hydrocephalus. [141] NLE can also manifest as a congenital atrioventricular conduction block, [142] with as many as 1-5% of pregnancies in mothers with anti- SSA/SSB antibodies leading to heart block, rising to a 6-25% risk for subsequent pregnancies after one affected child is born. [143]
If you or a loved one has been diagnosed with the autoimmune disease systemic lupus erythematosus or any of the less common subtypes of lupus, you may be wondering about available treatment options and which ones may be right for you. Because lupus is a chronic disease, doctors work with you to manage symptoms — which can range from mild arthritis and rash to problems with the kidneys and other organs — using a variety of medications and therapies. And the best treatment approach for you might change over time as your symptoms and the condition changes.

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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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