Unfortunately, there are no widely accepted diagnostic criteria for SLE. However, many doctors use the American College of Rheumatology (ACR) 11 common criteria. These criteria were designed to identify subjects for research studies, so they are very stringent. If you currently have four or more of these criteria or if you've had them in the past, chances are very high that you have SLE. However, having less than four doesn't rule out SLE. Again, additional testing may be necessary to inform a formal diagnosis. These criteria include:
While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap — sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). A person may have two or more co-existing chronic pain conditions. Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia. It is not known whether these disorders share a common cause.
The first mechanism may arise genetically. Research indicates SLE may have a genetic link. SLE does run in families, but no single causal gene has been identified. Instead, multiple genes appear to influence a person's chance of developing lupus when triggered by environmental factors. HLA class I, class II, and class III genes are associated with SLE, but only classes I and II contribute independently to increased risk of SLE. Other genes which contain risk variants for SLE are IRF5, PTPN22, STAT4, CDKN1A, ITGAM, BLK, TNFSF4 and BANK1. Some of the susceptibility genes may be population specific.
Since other diseases and conditions appear similar to lupus, adherence to classification can greatly contribute to an accurate diagnosis. However, the absence of four of these criteria does not necessarily exclude the possibility of lupus. When a physician makes the diagnosis of SLE, s/he must exclude the possibility of conditions with comparable symptoms, including rheumatoid arthritis, systemic sclerosis (scleroderma), vasculitis, dermatomyositis and arthritis caused by a drug or virus.
Subacute cutaneous: The skin symptoms of subacute cutaneous lupus are usually mild. People with this condition, which is also its own form of lupus, present with reddish-purple plaques, which are firm and raised, flattened skin lesions. These plaques can be found alone or in groups and range in size from 5 mm to 20 mm, usually appearing on the trunk, including the upper chest and back. About 10 percent of people with SLE have subacute cutaneous lupus. Certain drugs may also cause subacute cutaneous lupus.
Drug-induced lupus erythematosus is a (generally) reversible condition that usually occurs in people being treated for a long-term illness. Drug-induced lupus mimics SLE. However, symptoms of drug-induced lupus generally disappear once the medication that triggered the episode is stopped. More than 38 medications can cause this condition, the most common of which are procainamide, isoniazid, hydralazine, quinidine, and phenytoin.
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These are low in nutrients and may also contribute to poor digestion, weight gain, inflammation and other symptoms. Most also contain gluten, a type of protein found in wheat, barley, rye and most flour-containing products. Gluten sensitivity or intolerance is common in those with autoimmune disorders because gluten can be difficult for many people to digest properly, increasing leaky gut syndrome and triggering symptom flare-ups. (6)
Anitphospholipid Antibodies (APLs): Phospholipids are antibodies that are present in approximately one out of every two people with lupus. A positive test can help confirm diagnosis as well as help identify women with lupus who have certain risks (like blood clots and miscarriage) that would require preventative treatment and monitoring. Note that the presence of phospholipids also occurs in people without lupus and therefore, there presence alone is not enough for a lupus diagnosis.
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.
Lupus is an inflammatory autoimmune disease that can affect multiple parts of the body including the various organ systems. Doctors prescribe traditional pharmaceutical medications to manage symptoms and prevent flare ups of the disease that can cause more serious problems and complications. Many patients choose to supplement their pharmaceutical care with alternative treatments and lifestyle adjustments like using diet and exercise to minimize lupus symptoms. We discuss this further in our blog, Lupus/Chronic Illness: The Mind/Body Connection. There exists two major diets widely discussed in the autoimmune world. One is the anti-inflammatory diet and one is called the Paleo Diet.
What is known is that lupus is a chronic autoimmune disease (Healthdirect, 2016); meaning, that for people with lupus, their immune system attacks their healthy cells and tissues and not just foreign bodies/invaders (NIH, 2014). Evidently, this can lead to bodily damage. In the most common form of lupus, SLE (systemic lupus erythematosus), nearly all parts of the body can be affected (Healthdirect, 2016).
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.
Lupus in children tends to be more aggressive than in adults, says Dr. Pascual. The exact reasons for this are not understood. One theory is that people are born with genetic susceptibility to the disease that may be triggered by environmental factors such as a virus. “Children with the condition may have inherited a more complex set of predisposing genes,” she says. But this theory has yet to be proved.
“There’s no specific diet for lupus, but the Mediterranean-style diet comes close to what’s most ideal," says Sotiria Everett, RD, a clinical assistant professor in the department of family, population, and preventive medicine at Stony Brook School of Medicine in New York. "You want to eat a diet that’s low in fat and sugar and has lots of fruits and vegetables. You should get some of your protein from fish and eat lots of beans and legumes because they’re high in fiber, vitamin B, and iron."
People with SLE need more rest during periods of active disease. Researchers have reported that poor sleep quality was a significant factor in developing fatigue in people with SLE. These reports emphasize the importance for people and physicians to address sleep quality and the effect of underlying depression, lack of exercise, and self-care coping strategies on overall health. During these periods, carefully prescribed exercise is still important to maintain muscle tone and range of motion in the joints.
Today, physicians treat lupus using a wide variety of medicines, ranging in strength from mild to extremely strong. Prescribed medications will usually change during a person’s lifetime with lupus. However, it can take months—sometimes years—before your health care team finds just the right combination of medicines to keep your lupus symptoms under control.
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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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