|Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is the most common form of lupus. Lupus is
an autoimmune disease—a disorder in which the body
harms its own healthy cells and tissues. This leads to inflammation and damage
of body tissues in the joints, skin, kidneys, heart, lungs, blood vessels,
and/or the brain. Lupus is also considered a rheumatic disease because it can
cause aches, pain, and stiffness in the joints, muscles, and bones.
Lupus usually first affects people between the ages of 15 and 45 years, but
it can also occur in childhood or later in life. Patients experience periods of
chronic disease and remission. The prevalence of the disease is not precisely
known, ranging from an estimated 15 to 50 cases per 100,000 people.
|Signs and Symptoms|
Lupus is often accompanied by the following signs and
- Extreme fatigue
- Painful or swollen joints (arthritis)
- Muscle pain and stiffness
- Unexplained fever
- Skin rashes
- Kidney problems
- Hair loss
- Nausea, vomiting, abdominal pain
- Headaches, migraine, seizures, stroke
- Depression, anxiety, confusion
- Photosensitivity (sensitivity to
|What Causes It?|
The cause of lupus is unknown. Researchers believe that there is probably no
single cause but rather a combination of genetic, environmental, and possibly
hormonal factors that work together.
|Who's Most At Risk?|
The following categories of people are at higher than average risk for
- Many more women than men have lupus.
- Lupus is more common in black women and women of Hispanic, Asian, and
Native American descent than in white women.
- Lupus can run in families, but the risk that a child or a brother or
sister of a patient also will have lupus is quite
|What to Expect at Your Provider's Office|
If you are experiencing symptoms associated with lupus, you should see your
health care provider. A team of specialists usually becomes involved in making a
diagnosis and determining which treatment or combination of therapies will work
best for you. Because lupus is so complex, reaching a diagnosis may take time
and occurs gradually as new symptoms appear.
A diagnosis of lupus is based on a physical examination and the results of
laboratory tests, including the following.
- Complete blood count
- Erythrocyte sedimentation rate (ESR)—an
elevated ESR indicates inflammation in the body
- Blood chemistries
- Complement test (a blood test that measures severity of
- Antinuclear antibody test (ANA)—positive in
most lupus patients; other antibody tests
- Syphilis test (may be falsely positive in people with
- Skin or kidney biopsy
Imaging techniques may be used to evaluate central nervous system changes or
problems and other symptoms associated with lupus.
While lupus itself cannot be prevented, there are ways to prevent flare-ups.
These include the following.
- Avoiding sun exposure, high-dose birth control pills, penicillin, and
sulfonamides (anti-bacterial agents)
- Exercising regularly
- Receiving flu and pneumococcal
There is no known cure for lupus. However, your team of health care
professionals can develop a treatment plan to prevent flare-ups, to treat them
when they do occur, and to minimize complications.
Your health care provider may prescribe the following
- Corticosteroid hormones, to rapidly suppress inflammation. For
patients who cannot take corticosteroids, a type of immunosuppressive drug
called methotrexate may be used.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), to control pain,
swelling, and fever
- Antimalarials, to treat fatigue, joint pain, skin rashes, and
inflammation of the lungs, and to prevent flare-ups from recurring.
- Immunosuppressives, which restrain the overactive immune system by
blocking the production of some immune cells and curbing the action of
- Intravenous gamma globulin, a blood protein that increases immunity,
helps fight infection, and controls acute
|Surgical and Other Procedures|
Surgery is sometimes performed for lupus-related
|Complementary and Alternative Therapies|
A comprehensive treatment plan for lupus may include a range of complementary
and alternative therapies.
Nutritional tips for patients with lupus include the
- Eliminate all suspected allergens, including dairy, wheat (gluten),
soy, chocolate, eggs, corn, and preservatives; avoid alfalfa sprouts. Your
provider may want to test for food sensitivities.
- A modified fast of five to seven days at two-week intervals may be
helpful, especially during flare-ups. A modified fast can consist of eating
fruits, vegetables, and fish or vegetable protein.
- Avoid coffee, alcohol, and smoking.
- Minimize red meat and saturated fats to decrease
Potentially beneficial nutrient supplements include the
- Omega-3 fatty acids such as flaxseed and fish oils decrease
- Beta-carotene (50 mg three times a day), although some controversy
exists about the use of vitamin A. Check with your health care provider before
- Vitamin B12 (1,000 mcg via injection once or twice a week)
to heal lesions.
- Vitamin E (800 IU per day)
- Hydrochloric acid to decrease symptoms.
- DHEA (start at 5 mg three times a day and work up to 100 mg per day)
to reduce symptoms in mild to moderate lupus, with incremental benefits over
three to twelve months. Note: Tryptophan should be avoided in patients with
- Melatonin (20 mg before bed) has been shown to be helpful in many
autoimmune diseases. Take a lower dose if drowsiness occurs.
- Methylsulfonylmethane (MSM) (3,000 mg twice a day) helps prevent joint
and connective tissue breakdown.
- Iron can increase inflammation. Avoid it unless you are anemic (have
low red blood cells).
Mix dandelion (Taraxacum officinale), yellowdock (Rumex
crispus), echinacea (Echinacea purpurea), and garlic (Allium
sativum) equal parts in a tea, 1 cup three times daily. Herbs may be useful
for treating lupus, as well as secondary symptoms, such as depression and
An experienced homeopath can prescribe a regimen for treating lupus that is
designed especially for you. Some of the most common acute remedies are listed
- Arsenicum album for restless exhaustion
- Calcarea carbonica for overworked, overwhelmed people with poor
stamina and low back pain
- Nux vomica for irritability with constipation and sharp,
- Tuberculinum for repeated chest infections and joint pain with
Acute dose is three to five pellets of 12X to 30C every one to four hours
until symptoms are relieved.
Acupuncture may help balance immune response during remissions, and alleviate
The prognosis for lupus patients is mixed. Half of lupus patients who go into
remission remain so for decades, but 90 percent of patients have complications.
For women, symptoms tend to decrease after menopause. Ninety percent of patients
have a survival rate of 10 years, and 63 to 75 percent have a survival rate of
20 years. Patients with certain complications from lupus tend to have a poor
prognosis. The major cause of lupus-related death is
Patients need to be closely monitored during flare-ups to determine the
appropriate course of treatment and induce remission.
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|Review Date: March 2000|
|Reviewed By: Participants in the review process include: Shiva Barton, ND, Wellspace,
Cambridge, MA; Peter Hinderberger, MD, PhD, Ruscombe Mansion Community Health
Center, Baltimore, MD; Lonnie Lee, MD, Internal Medicine, Silver Springs,
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