Lupus diagnosis and treatment
Lupus is a chronic disease with no cure. This means that you can manage it with treatment, but it will not go away. Treatment can help improve your symptoms, prevent flares, and prevent other health problems often caused by lupus. Your treatment will depend on your symptoms and needs.
How is lupus diagnosed?
Lupus can be hard to diagnose because it has many symptoms that are often mistaken for symptoms of other diseases. Many people have lupus for a while before they find out they have it. If you have symptoms of lupus, tell your doctor right away.
No single test can tell if a person has lupus. But your doctor can find out if you have lupus in other ways, including:
- Medical history. Tell your doctor about your symptoms and other problems. Keep track of your symptoms by writing them down when they happen. Also, track how long they last.
- Family history of lupus or other autoimmune diseases. Tell your doctor if lupus or other autoimmune diseases run in your family.
- Complete physical exam. Your doctor will look for rashes and other signs that something is wrong.
- Blood and urine tests. The antinuclear antibody (ANA) test can show if your immune system is more likely to make the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not always mean you have lupus. If you test positive for ANA, your doctor will likely order more tests for antibodies that are specific to systemic lupus erythematosus (SLE).
- Skin or kidney biopsy. A biopsy is a minor surgery to remove a sample of tissue. The tissue is then viewed under a microscope. Skin and kidney tissue looked at in this way can show signs of an autoimmune disease.
Your doctor may use any or all of these tests to make your diagnosis. They also can help your doctor rule out other diseases that can be confused with lupus.
How is lupus treated?
There is no cure for lupus but treatments can help you feel better and improve your symptoms. Your treatment will depend on your symptoms and needs. The goals of treatment are to:
- Prevent flares
- Treat symptoms when they happen
- Reduce organ damage and other problems
Your treatment might include medicines to:
- Reduce swelling and pain
- Calm your immune system to prevent it from attacking the organs and tissues in your body
- Reduce or prevent damage to the joints
- Reduce or prevent organ damage
What types of medicines treat lupus?
Several different types of medicines treat lupus. Your doctors and nurses may change the medicine they prescribe for your lupus as your symptoms and needs change.
Types of medicines commonly used to treat lupus include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen and naproxen, help reduce mild pain and swelling in joints and muscles.
- Corticosteroids. Corticosteroids (prednisone) may help reduce swelling, tenderness, and pain. In high doses, they can calm the immune system. Corticosteroids, sometimes just called “steroids,” come in different forms: pills, a shot, or a cream to apply to the skin. Lupus symptoms usually respond very quickly to these powerful drugs. Once this has happened, your doctor will lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. Stopping this medicine suddenly can harm your body.
- Antimalarial drugs. Medicines that prevent or treat malaria also treat joint pain, skin rashes, fatigue, and lung inflammation. Two common antimalarial medicines are hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen). Studies found that taking antimalarial medicine can stop lupus flares and may help people with lupus live longer.
- BLyS-specific inhibitors. These drugs limit the amount of abnormal B cells (cells in the immune system that create antibodies) found in people with lupus. A common type of BLyS-specific inhibitor that treats lupus symptoms, belimumab, blocks the action of a specific protein in the body that is important in immune response.
- Immunosuppressive agents/chemotherapy. These medicines may be used in severe cases of lupus, when lupus affects major organs and other treatments do not work. These medicines can cause serious side effects because they lower the body’s ability to fight off infections.
- Other medicines. You may need other medicines to treat illnesses or diseases that are linked to your lupus — such as high blood pressure or osteoporosis. Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (“blood thinners”), such as warfarin or heparin, to prevent your blood from clotting too easily. You cannot take warfarin during pregnancy.
Talk to your doctor:
- About any side effects you may have
- If your medicines no longer help your symptoms
- If you have new symptoms
- If you want to become pregnant
- About any vitamins or herbal supplements you take — they might not mix well with medicines you use to treat lupus
Can I treat my lupus with alternative medicine?
Some people with lupus try creams, ointments, fish oil, or supplements they can buy without a prescription. Some people try homeopathy or see a chiropractor to care for their lupus. Some people with lupus who try these types of treatments say that they help.
Research studies have not shown any benefits to these types of treatments. And research studies have not been done to see if these treatments hurt people with lupus.
Talk to your doctor or nurse before trying any alternative medicine. Also, don’t stop or change your prescribed treatment without first talking to your doctor or nurse.
Will I need to see a special doctor for my lupus?
Maybe. Start by seeing your family doctor and a rheumatologist, a doctor who specializes in the diseases of joints and muscles such as lupus. Depending on your symptoms or whether your organs have been hurt by your lupus, you may need to see other types of doctors. These may include nephrologists, who treat kidney problems, and clinical immunologists, who treat immune system disorders.
Can I die from lupus?
Yes, lupus can cause death. But, thanks to new and better treatments, most people with lupus can expect to live long, healthy lives. The leading causes of death in people with lupus are health problems that are related to lupus, such as kidney disease, infections, and heart disease.1,2
Work with your doctor to manage lupus. Take your medicine as your doctor tells you to and make healthy choices, such as not smoking, eating healthy foods, getting regular physical activity, and managing your weight. Learn more about eating healthy in our Living with lupus section.
What research is being done on lupus?
Research on lupus focuses on:
- The genes that play a role in lupus and in the immune system
- Ways to change the immune system in people with lupus
- Different symptoms and effects of lupus in different racial and ethnic groups
- Things in the environment that may cause lupus
- The role of hormones in lupus
- Birth control pills and hormone therapy use in women with lupus
- Heart disease in people with lupus
- The causes of nervous system damage in people with lupus
- Treatments for lupus
- Treatments for organ damage caused by lupus, including stem cell transplantation
- Getting a better idea of how many Americans have lupus
Did we answer your question about lupus diagnosis and treatment?
For more information about lupus diagnosis or treatment, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:
- Sacks, J.J., et al. (2002). Trends in deaths from systemic lupus erythematosus—United States, 1979–1998. MMWR;51(17):371–374.
- Zeller, C.B., Appenzeller, S. (2008). Cardiovascular Disease in Systemic Lupus Erythematosus: The Role of Traditional and Lupus Related Risk Factors. Curr Cardiol Rev.; 4(2): 116-122.