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Systemic Lupus Erythematosus

When to Seek Medical Care
  • When to call the doctor
  • When to go to the hospital
    • Fever greater than 102°F
    • Rapidly decreasing urine volume
    • Chest pain
    • Sudden onset or unusual shortness of breath
    • Sudden onset of weakness
    • Severe headache
    • Acute visual changes
    • Sudden onset of abdominal pain
    • Inability to bear weight or move a swollen joint due to severe pain
    • Rapid swelling of one or more extremities (arms, legs, hands, or feet)

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Self-Care at Home

Home care for lupus generally involves taking the prescribed medications and adhering to good practices such as using sunscreen because there is often a history of skin sensitivity to sunlight.

  • People with sun-induced rashes should always wear a high SPF lotion that blocks both UVA and UVB types of ultraviolet light.
  • Those taking oral steroid therapy or immune suppressing agents should be vigilant if a fever develops, since fever can occur with lupus flares or with a superimposed problem, especially infection.
  • A combination of rest, especially during flares, and exercise for joints and muscles is important and should be supervised by the treating physician and physical therapists.
Outlook

The prognosis varies depending on whether there is serious organ inflammation (for example kidney or brain involvement).

Many lupus patients have very limited disease and live relatively normal lives with minimal problems. Others have multi-organ involvement with kidney failure,  heart attacks  , and strokes  . The diversity of outcomes reflects the diversity of the disease.

With respect to fertility, women with lupus are just as capable of becoming pregnant and having children as the general population. However, there is a much higher occurrence of complications in pregnancy  — especially if the kidneys   are involved. Women whose lupus has been inactive for 6-12 months are more likely to have a successful pregnancy. In addition, antibodies formed in the mother that are transferred from mother to fetus can occasionally affect the infant, leading to rashes, low blood counts, or more seriously a slow heart rate due to complete heart block (neonatal lupus). For these reasons, all women with lupus who are or who desire to become pregnant should consult with their treating rheumatologist or other treating physicians and should be referred for "high-risk" obstetric care.

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