Various Treatments Administered to Patients with Lupus

Due to the complexity of lupus, the treatment for the disease can take various forms, consisting of an extensive range of medications and therapies aimed at easing the lupus symptoms and preventing the occurrence of further complications. Due to the fact that the immune system has a major contribution to the occurrence and the progression of lupus, (harming the body?s own healthy cells and tissues instead of fighting against antigens) the disease can affect any part of the body, determining impairments of multiple body systems.

The treatment of lupus greatly differs from a patient to another, lupus sufferers receiving a certain type of medications according to their experienced symptoms and the seriousness of the disease. Thus, the treatment of lupus is often personalized, comprising many different types of medications and therapies. Lupus patients (especially patients diagnosed with systemic lupus erythematosus) are commonly administered combination treatments, targeted at countering the occurrence and aggravation of the multitude of symptoms characteristic to this type of autoimmune disease.

Although at present there is no specific cure for lupus, the existing treatments can greatly ameliorate the symptoms of the disease and minimize the risk of complications. Lupus often has an unpredictable pattern of progression, producing symptoms that come and go over time. Thus, most lupus treatments are aimed at prolonging the periods of remission and ameliorating the phases of relapse. Once a patient is diagnosed with lupus, he/she will receive a treatment according to age, gender, overall health condition, symptomatic intensity, as well as lifestyle. With the right medication plan, patients can keep the disease under control and even live normal and healthy lives. Today?s treatments are efficient in easing the symptoms of lupus and they also allow patients to carry on with their usual daily activities. Most patients with lupus don?t require prolonged hospitalization and bed confinement is rarely needed.

The treatment of lupus is individualized, aiming to meet the needs and symptoms of the patient. For instance, for patients who suffer from musculoskeletal conditions due to lupus, doctors commonly prescribe treatments with medications that reduce inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are extensively administered to patients confronted with symptoms such as joint swelling, stiffness and pain, muscular weakness and fever.

Nonsteroidal anti-inflammatory drugs can either be administered alone or in combination with similar medications. Due to the fact that such medications can produce serious side-effects, it is recommendable to avoid long-term use. Nonsteroidal anti-inflammatory drugs should be administered only during the periods of relapse, when the symptoms of lupus suddenly increase in intensity. Popular NSAIDs are: ibuprofen, naproxen, sulindac, diclofenac, ketoprofen, diflunisal, nabumetone, indometacin and oxaprozin. In order to minimize their side-effects, you should respect your doctor?s exact instructions when using such medications.

Another type of commonly used medications are antimalarials. Originally prescribed in the treatment of malaria, these medications are also efficient in the treatment of lupus, as they tend to suppress a series of processes at the level of the immune system, neutralizing some of its undesirable effects on the organism. Antimalarials used in the treatment of lupus include: hydrochloroquine (Plaquenil), quinacrine (Atabrine) and chloroquine (Aralen). These commonly used lupus medications are prescribed to ease fatigue, joint inflammation and pain, skin rashes and inflammation of the lungs and heart. Unlike NSAIDs, antimalarials have less serious side-effects, rendering them appropriate for long-term treatments. Ongoing treatment with antimalarials can efficiently prevent the occurrence of flares.

Corticoid steroids are often prescribed in the treatment of lupus. Corticosteroided hormones such as prednisone, hydrocortisone, methylprednisolone and dexamethasone are usually prescribed in small doses to reduce inflammation. Due to the fact that these medications can produce serious side-effects, they are only prescribed in short-term treatments. For patients confronted with severe forms of lupus, doctors usually prescribe immunosuppressive drugs such as azathioprine and cyclophosphamide. The main action of immunosuppressive medications is to minimize the damage caused by the impaired, overactive immune system at cellular level. Although immunosuppressive drugs are very efficient in easing the symptoms of lupus, they are known to cause dependency and thus they shouldn?t be prescribed in long-term treatments.

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Difficulties in Diagnosing Lupus

Due to its polyvalent character and its intrinsic nature (lupus is triggered and augmented by severe immune system impairments), lupus is very difficult to diagnose accurately and promptly. In some cases, the complexity of lupus renders doctors unable to reveal its presence in time, the unspecific symptoms produced by the autoimmune disease often being misleading in the process of establishing the correct diagnosis. It may take months or even years to confirm the diagnosis received by patients with suspected lupus. The process of diagnosing lupus can be challenging even for the most experienced doctors. Patients can also influence the duration of the process of diagnosis, as doctors often rely on symptomatic reports apart from common laboratory analyses and physical examinations. The challenging process of diagnosing lupus can only be accelerated and facilitated by good doctor-patient cooperation.

Although at present there aren't any specific tests that can reveal the presence of lupus, the existing laboratory tests can still help doctors decide upon the correct diagnosis. The most commonly used method of diagnosing patients with suspected lupus consists in looking for the presence of auto-antibodies in blood samples. The antinuclear antibody test (ANA test) is nowadays extensively used to detect the presence of auto-antibodies in patients with suspected lupus. However, the main problem with the ANA test is that it isn't 100 percent accurate. For instance, a positive result for the ANA test may be influenced by factors such as past infections, chronic diseases or prolonged treatments with certain medications and not by the actual presence of lupus. In order to confirm the presumptive diagnosis, doctors have to rely on various other tests, such as anti-DNA, anti-RPN, anti-Ro, anti-La, or anti-Sm antibody tests.

When these previously mentioned blood tests along with clinical examinations and the patient's symptomatic report are inconclusive for establishing the correct diagnosis, doctors may decide to perform biopsies of the skin or kidneys in order to reveal clear evidence of lupus. Additional tests often include the test for syphilis, as lupus sufferers commonly have a series of antibodies that generally occur in patients with syphilis. Thus, a falsely positive result for the syphilis test is also considered to be an indicator for lupus. Doctors have to rely on a wide range of tests in order to analyze the disease from different angles and find the accurate diagnosis. Without multiple medical investigations and elaborate research, lupus is virtually impossible to diagnose properly.

Once lupus has been appropriately diagnosed, doctors still depend on a series of tests in order to identify the actual type of lupus and its rate of progression. In order to gather the required medical information, doctors may choose to perform the following tests: complete blood count (CBC), blood chemistry tests, erythrocyte sedimentation tests and urinalysis. After the results of these tests are properly interpreted, doctors can finally choose the appropriate course of medications. Due to the fact that the process of diagnosing lupus is time consuming, patients may have developed serious complications by the time they receive the appropriate medical treatment. Despite their limited relevancy, the existing procedures of diagnosis are the only means of revealing signs of lupus in patients. Medical scientists are hoping to find more efficient methods of diagnosing lupus in the near future, methods that can simplify the process of diagnosis and allow prompt medical intervention.

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Classification of Lupus Types

Due to the fact that it involves impairments of the immune system and determines the body to destroy its own healthy cells and tissues, lupus is defined as an autoimmune disease. A major characteristic of lupus and autoimmune diseases in general is the multitude of generated symptoms. When the compromised immune system becomes confused and targets healthy blood cells and tissues instead of external antigens, the disease can affect virtually any part of the body, producing a wide variety of symptoms that are often uncharacteristic to autoimmune diseases in general. Lupus commonly affects the joints, skin, blood vessels, heart, lungs and even the brain (central nervous system). The symptoms generally produced by lupus and other similar autoimmune diseases have an unspecific character, often being misleading in diagnosing the disease. Lupus often generates symptoms such as pronounced fatigue, body weakness, pain, swelling and stiffness of the joints, fever, kidney affections and skin rashes.

Medical scientists haven?t yet been able to find a cure for lupus. In the absence of a specific cure, doctors can only control the symptoms produced by the disease and prevent the occurrence of further complications. With the appropriate treatment, the majority of patients diagnosed with lupus can live healthy and active lives. The progression of lupus is fluctuant and unpredictable, the disease alternating between periods of symptomatic exacerbation and periods of remission. The main goal of the existing treatments of lupus is to prolong the periods of remission and to ease the phases of relapse. Medical scientists hope that in the near future they will be able to come up with an efficient cure for lupus, a treatment that can gradually reverse the effects produced by the disease and prevent the occurrence of flares. The ongoing research upon this matter will probably result in finding the specific cure for lupus in the following couple of years.

The term ?Lupus? comprises a variety of distinctive types that can be classified as follows:

Systemic Lupus Erythematosus, (SLE), the most common type of lupus, has a pronounced polyvalent character. The systemic form of lupus can affect multiple parts of the body and cause a wide variety of unspecific symptoms, ranging from mild to severe. Despite the fact that SLE commonly affects people with ages between 15 and 40, it can also affect the very young or the elderly. Systemic lupus is considered a highly problematic disease, being difficult to diagnose and often requiring ongoing combination treatments.

Discoid Lupus Erythematosus is a type of lupus that primarily affects the skin. In the absence of the appropriate treatment, discoid lupus can become systemic over the course of time. In its first stages of progression, discoid lupus produces inflammation and rashes on the face, scalp, or other body regions. In time, the rashes become prominent, thickened and may even increase in size. The skin lesions caused by discoid lupus may also involve scaling and blistering. Although lupus rashes may ameliorate or even completely clear up with the aid of treatment, they tend to recur after a certain amount of time.

Drug-induced lupus is a rare form of the disease that occurs as a result of medication intolerance. This type of lupus produces symptoms that are very similar to systemic lupus erythematosus: rash, unexplained fever, pulmonary and coronary affections, and arthritis. However, unlike the systemic form of the disease, drug-induced lupus doesn?t involve kidney impairments and often disappears as soon as the causative drugs are no longer administered. The most common medications that have been identified to cause drug-induced lupus are: hydralazine (Apresoline), methyldopa (Aldomet), procainamide (Procan), isoniazid (INH), quinidine (Quinaglute), phenytoin (Dilantin) and carbamazepine (Tegretol).

The last type of lupus refers to the neonatal form of the disease. Neonatal lupus is a very rare disease that affects newborn babies of mothers diagnosed with systemic lupus erythematosus or other similar autoimmune diseases. Infants affected by this type of lupus often suffer from congenital heart and circulatory problems. Sometimes, infants with neonatal lupus may also suffer from liver conditions and skin affections. When the disease is promptly diagnosed, the young patients? life expectancy and overall condition can be improved with treatment. Prompt medical intervention is crucial for patients with suspected neonatal lupus.

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