Systemic lupus erythematosus (SLE/Lupus) is an autoimmune disease. Normally, immune system helps to protect our body from many bad things like infections and cancer. In autoimmune diseases like lupus, one’s own immune system starts attacking its own cells and tissues. It can occur at any age (mostly 15 to 45 years but can occur in children too). It is seen more in women than in men. SLE / Lupus mean the same disease.

The exact cause of SLE is not known. The risk of lupus is associated with some genes present in one’s body. It has also been found to be associated with environmental factors like sunlight exposure, certain medications, viruses, stress etc. However, in most patients, we don’t find any single gene or environment factor. Mostlikely,it is a combination of many things which causes someone to have SLE.

SLE can affect any system or organ of the body. Lupus patients can develop many different types of symptoms.
The most common lupus symptoms are,

• Fatigue or tiredness
• Skin rashes, which get worse on exposure to sunlight. Many patients have a butterfly shape (malar) rash on face.
• Joint pain, stiffness more in mornings and joint swelling
• Frequent ulcers (or sores) in mouth or nose
• Hair fall / loss
• Lupus patients can also have following symptoms or problems
• Weight loss
• Frequent fevers without any infections detected
• Headaches and brain problems (like fits or seizures, mood swings, difficulty to think clearly, sudden psychotic or unusual behavior, stroke or paralysis)
• Swelling and puffiness of hands, feet or eyes
• Eye problems – redness, vision problems
• Muscle weakness
• Recurrent miscarriages, blood clots etc
• Vomiting, loose stools
• Get cold hands and feet, which change color to white or blue, especially when exposed to cold
• Passing less urine

Also, having above symptoms doesn’t itself mean one surely has lupus. Many of these symptoms like hair fall, fatigue, oral ulcers, swelling etc. are pretty common in people without having lupus. A Rheumatologist makes sure that a patient is not having these symptoms due to other common causes.

Lupus is a variable and unpredictable disease and can be life threatening for a minority of patients whose vital organs like kidneys, brain, heart, blood etc. are affected. However, with modern treatments and careful monitoring of the condition the disease can be brought under control in most patients.

When one thinks that a patient has lupus, it is best to get the patient evaluated by a Rheumatologist. They go into details of symptoms, examine, and after various investigations (blood tests, X ray, urine tests etc.), can make or reject a diagnosis of SLE. SLE investigations can be very difficult to interpret and no single test can confirm it. Hence, only an expert should make a diagnosis of SLE. Once it is confirmed that a patient has SLE, we may have to do more investigations to find which organs are involved.

Lupus cannot be cured but it can very well be controlled. A number of different drugs may be needed depending on which symptoms you experience

Different types of drugs can be used to treat lupus. These are advised according to how severe the disease is and what organs are involved in the patient. The main aim of treatment is to bring lupus disease under control and prevent organ damage. The drugs used in lupus are to control the overactive immunity which is attacking patient’s own body. They also help to decrease the inflammation in various organs.

Non-steroidal anti-inflammatory drugs (NSAIDS) : These are drugs like ibuprofen, naproxen etc, especially given if patient has joint pains.

Medicines like hydroxychloroquine and chloroquine :They were originally discovered to treat malaria, but can help a lot in lupus patients.

Steroids and other medications (like methotrexate, azathioprine, mycophenolate, cyclophosphamide, rituximab etc.): These help to control or suppress the overactive immune system. Steroids are usually used only at start when disease is moderate to severe. They are very helpful to control disease to give relief and prevent organ damage. Later we use other medications and decrease steroids to maintain the control.Experts in treating SLE use the drugs given below in best possible way to avoid or minimize the side effects.

There are higher chances of problems in pregnancy in SLE females as compared to normal female pregnancies. It is important to let your treating Rheumatologist know if you want to plan a pregnancy in near future. The expert can guide you and take proper measures to avoid problems in pregnancy. For example, they will advise avoiding pregnancy if your disease is active. However, once your disease is well controlled for at least 6 months, pregnancy can be safely planned under doctor’s advice.

Have a healthy lifestyle: It can help lupus patients a lot. Eat healthy diet - lots of vegetables, fruits, nuts, dairy products, avoid sugar and refined foods etc. Stay active. Even mild home based exercises, walking and using stairs whenever possible etc are good ways to stay active – It helps Lupus patients to keep muscles and bones strong. Avoid smoking or other addictions. Try to avoid / manage mental and physical stress. One can consider doing relaxation exercises – like meditation or mindfulness etc.

Avoid excess sun exposure: Sunlight can cause a lupus rash to flare and may even trigger a serious flare of internal organs itself. Use a good sunscreen with sun protection factor (SPF) of at least 30 or take doctor’s advice.

Show an expert in lupus (like a rheumatologist) : Follow their directions

Get educated about SLE: It is very important for patients to have good information and be educated about their disease, so that they can take better treatment decisions. They should ask their doctor to provide with patient information material.