Lupus (cont.)

An ANA test is done on a sample of a person's blood. The test determines the strength of the antibodies by measuring how many times the person's blood must be diluted to get a sample that is free of antibodies.

Does a Positive ANA Test Mean That I Have Lupus?

Not necessarily. The antinuclear antibody (ANA) test is positive in most people who have lupus, but it also may be positive in many people who are healthy or have another autoimmune disease. Therefore, a positive ANA test alone is not adequate for the diagnosis of lupus. There must be at least three additional clinical features from the list of 11 features for the diagnosis to be made.

How Is Lupus Treated?

The type of lupus treatment prescribed will depend on several factors, including the person's age, type of drugs he or she is taking, overall health, medical history, and location and severity of disease.

Because lupus is a condition that can change over time and is not always predictable, a critical part of good care includes periodic visits with a knowledgeable, accessible doctor, such as a rheumatologist.

Some people with mild features of the disease do not require treatment, while people with serious involvement (such as kidney complications) may require powerful medications. Drugs used to treat lupus include:

  • Steroids. Steroid creams can be applied directly to rashes. The use of creams is usually safe and effective, especially for mild rashes. The use of steroid creams or tablets in low doses can be effective for mild or moderate features of lupus. Steroids also can be used in higher doses when internal organs are threatened. Unfortunately, high doses also are most likely to produce side effects.
  • Plaquenil (hydroxychloroquine). Commonly used to help keep mild lupus-related problems, such as skin and joint disease, under control. This drug is also effective at preventing lupus flares.
  • Cytoxan (cyclophosphamide). A chemotherapy drug that has very powerful effects on reducing the activity of the immune system. It is used to treat severe forms of lupus, such as those affecting the kidneys or brain.
  • Imuran (azathioprine). A medication originally used to prevent rejection of transplanted organs. It is commonly used to treat the more serious features of lupus.
  • Rheumatrex (methotrexate). Another chemotherapy drug used to suppress the immune system. Its use is becoming increasingly popular for skin disease, arthritis, and other non-life-threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.
  • Benlysta (belimumab). This drug weakens the immune system by targeting a protein that may reduce the abnormal B cells thought to contribute to lupus. People with active, autoantibody-positive lupus may benefit from Benlysta when given in addition to standard drug therapy.
  • CellCept (mycophenolate mofetil). A drug that suppresses the immune system and is also used to prevent rejection of transplanted organs. It is being used increasingly to treat serious features of lupus, especially those previously treated by Cytoxan.
  • Rituxan (rituximab). A biologic agent used to treat lymphoma and rheumatoid arthritis. It is used to treat the most serious features of lupus when other therapies are not effective.

What Is the Outlook for People With Lupus?

The outlook for lupus varies, depending on the organs involved and the severity of symptoms. The disease often includes periods of symptoms followed by periods of remission or lack of symptoms. Most people with lupus can expect to have a normal lifespan, especially if they follow their doctor's instructions and their treatment plans.

What Can Be Done to Improve Quality of Life?

There is no cure for lupus, but there are steps you can take to improve your sense of well-being and your quality of life, including:

  • Exercise. Low-impact exercises, such as walking, swimming, and biking can help prevent muscle wasting and lower your risk for developing osteoporosis (thinning of the bones). Exercise also can have a positive impact on mood.
  • Get enough rest. Pace yourself, alternating periods of activity with periods of rest.
  • Eat well. People with lupus should eat a nutritious, well-balanced diet.
  • Avoid alcohol. Alcohol can interact with your medications to cause significant stomach or intestinal problems, including ulcers.
  • Don't smoke. Smoking can impair circulation and worsen symptoms in people with lupus. Tobacco smoke also has negative effects on your heart, lungs, and stomach.
  • Play it safe in the sun. People with lupus may develop rashes or disease flares when exposed to the sun. All lupus patients should protect themselves from the sun; wear sunglasses, a hat, and sunscreen when you go out in the sun.
  • Treat fevers. Take care of fevers and infections promptly. A fever may indicate an infection or a lupus flare-up.
  • Be a partner in your care. Build an honest and open relationship with your doctor. Be patient. It often takes time to find the right medication and dosage that works best for you. Also, follow your doctor's treatment plan and don't be afraid to ask questions.
  • Get to know your disease. Keep a record of your lupus symptoms, which parts of your body are affected and any situations or activities that seem to trigger your symptoms.
  • Ask for help. Don't be afraid to recognize when you need help and to ask for it. Consider joining a support group. It often helps to talk to others who have been through similar experiences.