Lupus
Also known as: Systemic Lupus Erythematosus, SLE
A complex autoimmune disease affecting multiple organ systems. Requires careful monitoring, targeted treatment, and a physician who understands its unpredictable course.
Key Facts
- Affects approximately 1.5 million Americans, 90% of whom are women
- Disproportionately affects African American, Hispanic, and Asian women
- No two lupus patients present the same way — it's called 'the great imitator'
- Kidney involvement (lupus nephritis) occurs in about 50% of patients
- Hydroxychloroquine reduces mortality and should be taken by almost all lupus patients
What is lupus?
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which the immune system attacks healthy tissue throughout the body. Lupus can affect the joints, skin, kidneys, brain, heart, lungs, and blood cells. It’s characterized by periods of flare and remission, and no two patients present the same way.
Lupus disproportionately affects women of childbearing age, particularly those of African American, Hispanic, and Asian descent, though it can occur in anyone.
Symptoms
- Joint pain and swelling (often mimicking RA)
- Butterfly-shaped facial rash (malar rash)
- Photosensitivity — skin reactions to sunlight
- Fatigue, often severe and persistent
- Mouth or nasal ulcers
- Hair loss
- Kidney involvement (lupus nephritis) — detected through urine and blood tests
- Chest pain with deep breathing (pleuritis or pericarditis)
- Raynaud's phenomenon (color changes in fingers with cold exposure)
How we diagnose it
- ANA (antinuclear antibody) — Positive in nearly all lupus patients, but not specific to lupus alone
- Specific antibodies — Anti-dsDNA, anti-Smith, antiphospholipid antibodies
- Complement levels (C3, C4) — Often low during active disease
- Complete blood count — May show low white cells, platelets, or anemia
- Urinalysis and kidney function — Screening for lupus nephritis
- Clinical criteria — Evaluated against established classification criteria (ACR/EULAR)
How we treat it
- Hydroxychloroquine — The foundation of lupus treatment for nearly all patients; reduces flares and organ damage
- Immunosuppressants — Mycophenolate, azathioprine, or cyclophosphamide for significant organ involvement
- Biologic therapy — Belimumab (Benlysta), available as an infusion in our on-site infusion center, or newer targeted therapies
- Corticosteroids — For acute flares, used at the lowest effective dose and tapered as quickly as possible
- Monitoring — Regular blood work, urinalysis, and clinical assessment to catch flares early and minimize organ damage
At Synergy Rheumatology
Lupus requires a physician who can manage its complexity across multiple organ systems and adjust treatment as the disease evolves. When biologic infusions like Benlysta are indicated, they're administered in our office. Patients with active lupus may also qualify for clinical trials evaluating new therapies at our research site.
Have questions about lupus?
Schedule an appointment to discuss your symptoms, diagnosis, or treatment options with Dr. Fellows.