02/13/02

Medical Management Topics Related to Systemic Lupus Erythematosus (SLE)

 While there are many medical issues related to this illness some common areas people with lupus have shown interest in are described below. For further information on any of these topics see the Resource Listing section and be sure to discuss any concerns with your doctor.

Tests:

A partial listing of some of the common tests that may be ordered by your doctor includes:

·         Blood count

·         Erythrocyte sedimentation rate

·         Kidney and liver assessment.

·         Urinalysis.

·         Antinuclear antibody (ANA) test

·         Chest X-ray

·         Electrocardiogram (ECG)

·         Syphilis test:   a false-positive to a syphilis test can indicate antiphospholipid antibodies in your blood which can be associated with an increased risk of blood clots, strokes and recurrent miscarriages. (Mayo Clinic, 2002)

For greater detail in test purpose and description refer to the Resource list for sources of information.

Course of Disease:

 “Persons living with SLE can expect to live a relatively normal life with intervals of remissions and flare-ups. By following the advice of their doctor, taking medication as prescribed, and seeking help for side-effects of medications or new symptoms, most people with an early diagnosis of SLE can look forward to a normal life span. Some people have severe flares requiring hospitalization and intensive treatment, but the majority are never hospitalized.”

 “Lupus is a serious condition, but diagnosis and treatment are improving. Today it can be treated and controlled. More and more people with lupus are finding that they can be active and productive.

One thing that makes a huge difference in living with lupus is the person's role in controlling the disease. We can deal better with the challenge of living with this or any chronic condition by learning all we can about the condition and by being aware of how our own body reacts.

Often, a person's flares follow a clear pattern, with the same combination of symptoms every time. An informed patient can watch for warning signs and alert the doctor early on.” ( Lupus Canada, 2001)

Signs & Symptoms of a Flare:

January 26, 1999

Lupus: A Patient Care Guide for Nurses
and Other Health Professionals

Patient Information

Patient Information Sheet #4, Preventing a Lupus Flare

Your doctor has put together a treatment plan that is designed specifically for you and your lupus. This probably includes physical and emotional rest, aggressive treatment of infections, good nutrition, and avoidance of direct sunlight and other sources of ultraviolet light. Your doctor may have also prescribed medications to control disease symptoms and other health problems that you might have. One of the most important ways you can help yourself is to understand your treatment plan and the things you need to do to keep your disease under control.

Sometimes, despite the treatment plan and your efforts, you may experience a lupus flare. A flare is a worsening of symptoms that signals increased disease activity. A variety of factors can cause a flare, and you should contact your doctor immediately if you suspect a flare is developing. The doctor will evaluate your condition and take steps to control the seriousness of the flare. He or she will also reevaluate your overall treatment plan and make any needed changes.

Warning Signs of a Flare

·         Increased fatigue

·         A new or higher fever

·         Increased pain

·         Development or worsening of a rash

·         Upset stomach

·         Headache or dizziness

·         Development of symptoms you haven’t had before

What Triggers a Flare?

A flare can be triggered by one factor or a combination of factors.
The most common are

·         overwork or not enough rest;

·         stress or an emotional crisis;

·         exposure to sunlight or other sources of ultraviolet light;

·         infection;

·         injuries or surgery;

·         pregnancy or the time right after the baby’s birth (the postpartum period);

·         sudden stopping of medications for lupus;

·         sensitivities or allergies to items that you put on your skin, such as hair dye, hair permanent solution, makeup, and skin creams;

·         certain prescription drugs;

·         over-the-counter medications, such as cough syrup or laxatives; and

·         immunization

From LUPUS: A Patient Care Guide for Nurses and Other Health Professionals, National Institute of Arthritis and Musculoskeletal and Skin Diseases/National Institutes of Health

(NIAMS, 1999, http://www.niams.nih.gov/hi/topics/lupus/lupusguide/chppis4.htm)

Common Medications:

Although there is no “cure” for Lupus many of the symptoms may be controlled with various medications This is done in conjunction with an overall personal management which could include wise nutrition choices, activity modifications, conservation of  energy, the 6-Ps (prioritizing, planning, pacing, protection, posture, & positivity), good sleep practises, joint protection and a regular exercise program.

Each individual will present with his or her own set of symptoms. The treatment plan should be tailored to your specific needs with your doctor. For your information some common medication categories that may be prescribed to you include:

·         Pain medications

·         Nonsteroidal anti-inflammatory drugs

·         Immunosuppressive medications

·         Antimalarial drugs

·         Corticosteroids

Discuss with your pharmacist or doctor what the benefits may be and what possible side effects may occur for each medication prescribed.