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Systemic Lupus Erythematosus: Diagnosis and Treatment
Diagnosis
A medical history and physical examination and blood testing are
used to diagnose the disease.
Treatment
- Dietary changes, physical activity, smoking cessation, and avoidance
of sun exposure are helpful nonmedical measures for managing SLE.
Pregnancy should be avoided during flare–ups, due to a high risk
of miscarriage and maternal complications.
- Measures to protect against direct and indirect sunlight exposure
are important, including daily using high–SPF sunscreen, wearing
long–sleeved shirts and wide–brimmed hats, and avoiding midday
sun.
- Low–impact, weight–bearing exercise is important for maintaining
cardiovascular and bone health in SLE patients.
- Nonsteroidal anti–inflammatory
drugs (e.g., ibuprofen) are used in patients with arthritis or
fever. However, there have been some reports of meningitis related
to ibuprofen use. Further, sulfa–containing drugs (e.g., celecoxib
capsules (Celebrex)) should be used with caution, as they may worsen
the disease. It is important to ask your physician before beginning
any drug, including over–the–counter medications and herbal therapies.
- Steroids
are frequently used during flare–ups. However, long–term steroid
use can negatively affect the bones. For this reason, dual energy
X–ray absorptiometry (DEXA) scanning may be helpful to monitor
bone health.
- Disease–modifying antirheumatic drugs (e.g., azathioprine,
hydroxychloroquine, and cyclophosphamide) may be useful in
advanced cases.
- Experimental therapies under investigation include
stem cell transplantation, antibodies, immunoglobulin, and thalidomide.
- Some
evidence suggests that patients may benefit from dehydroepiandrosterone
(DHEA). At doses of 200 mg/day, DHEA has been found to improve
the disease and reduce flare–ups. Some studies have also found
that use of DHEA decreases the need for steroids. However, the
potential adverse effects of DHEA on health are not fully known.
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