What to expect with Lupus?

Question: I have a friend’s whose adult daughter has been diagnosed with Lupus. She would like to know what to expect. We know that it is something that isn’t very predictable or typical but I am looking for what is “most” typical from most patients and what usually happens over the next 20 years or so. Right now only her joints are affected and she is able to work just fine. She isn’t in much pain but more of what she would describe as “disfomfort occasionally.” They just put her on medication (immunosuppressive) that didn’t work and have added a more powerful med (Imuran) that may make her sick. She was diagnosed with: Systemic lupus erythematosus (SLE)

Answers:
Systemic lupus erythematosus (SLE or lupus) is a chronic, potentially debilitating or fatal autoimmune disease in which the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but often harms the heart, joints (rheumatological), skin, lungs, blood vessels and brain/nervous system. Lupus is treatable, mainly with immunosuppression, though there is currently no cure for it.

The standard treatment has been a limited group of drugs (primarily corticosteroids, anti-malarials, and chemotherapy drugs). Plaquenil (hydroxychloroquine sulfate) is currently the only FDA approved anti-malarial for treating SLE. In 2005, CellCept became accepted for treatment of lupus kidney disease.

Treatment:
SLE is a chronic disease with no cure. There are, however, some medications, such as corticosteroids and immunosuppressants which can control the disease and prevent flares. Flares are typically treated with steroids, with DMARDs (disease-modifying antirheumatic drugs) to suppress the disease process, reduce steroid needs and prevent flares. DMARDs commonly in use are the antimalarials (e.g. hydroxychloroquine or methotrexate) and azathioprine. Hydroxychloroquine is used for constitutional, cutaneous, and articular manifestations. Cyclophosphamide is used for severe glomerulonephritis or other organ-damaging complications. Renal disease produces the most significant morbidity.

Patients who require steroids frequently may develop obesity, diabetes and osteoporosis. Hence, steroids are avoided where possible.

Measures such as avoiding sunlight (to prevent problems due to photosensitivity) may also have some effect.

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inflammation of the lining of the lungs. painfuls coughs, sore ribs. can't remember anything else.

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