Doc, do I have lupus?


Systemic Lupus Erythematosus (SLE) is an autoimmune disorder that may affect the joints, skin, kidneys, central nervous system and other vital organs. SLE is much more frequent in women than men (9 w. to 1 m.). SLE is more severe in Afro-Americans than in white people
Many times the disease starts with pain and swelling joints with a distribution very similar to rheumatoid arthritis. Most of the times, the joint involvement is indistinguishable from RA. This similarity is one the most frequent consultations to the rheumatologist because the patient wants to know if he/she has RA or lupus. Other characteristics, like sun sensitive skin rash (or skin rash no-sun sensitive), kidney involvement, haematological manifestations may give the clue to diagnosing lupus instead of RA. A blood test in SLE patients may detect some hematological abnormalities that suggest the diagnosis. However, is the presence of some antibodies, like ANA (antinuclear antibodies) and especially anti-DNA what will help definitively to establish the diagnosis.
Nonetheless, there are many patients with mild lupus that only require hydroxychloroquine and sometimes low doses of steroids for long periods of his/her life. When lupus is severe and involves vital organs, high doses of steroids and immunosuppressive drugs are the gold standard of the treatment.


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