It is dangerous to stop taking corticosteroids suddenly, so it
is very important that the doctor and patient work together in
changing the dose.
Immunosuppressives: For some patients whose
kidneys or central nervous systems are affected by lupus, a type
of drug called an immunosuppressive
may be used. Immunosuppressives, such as cyclophosphamide (Cytoxan)
and mycophenolate mofetil (CellCept), restrain the overactive
immune system by blocking the production of immune cells. These
drugs may be given by mouth or by infusion (dripping the drug
into the vein through a small tube). Side effects may include
nausea, vomiting, hair loss, bladder problems, decreased
fertility, and increased risk of cancer and infection. The risk
for side effects increases with the length of treatment. As with
other treatments for lupus, there is a risk of relapse after the
immunosuppressives have been
stopped.
Other Therapies: In some patients, methotrexate
(Folex, Mexate, Rheumatrex), a disease-modifying antirheumatic
drug, may be used to help control the disease. Working closely
with the doctor helps ensure that treatments for lupus are as
successful as possible. Because some treatments may cause
harmful side effects, it is important to report any new symptoms
to the doctor promptly. It is also important not to stop or
change treatments
without talking to the doctor first.
Alternative and Complementary Therapies:
Because of the nature and cost of the medications used to treat
lupus and the potential for serious side effects, many patients
seek other ways of treating the disease. Some alternative
approaches people have tried include special diets, nutritional
supplements, fish oils, ointments and creams, chiropractic
treatment, and homeopathy. Although these methods may not be
harmful in and of themselves, and may be associated with
symptomatic or psychosocial benefit, no research
to date shows that they affect the disease process or prevent
organ damage.
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Some alternative or complementary approaches may help the
patient cope or reduce some of the stress associated with living
with a chronic illness. If the doctor feels the approach has
value and will not be harmful, it can be incorporated into the
patient's treatment plan. However, it is important not to
neglect regular health care or treatment of serious symptoms. An
open dialogue between the patient and physician about the
relative values of
complementary and alternative therapies allows the patient to
make an informed choice about treatment options.
Because some treatments may cause harmful side effects...report
any new symptoms to the doctor promptly.
Systemic Lupus Erythematosus (SLE, or lupus) is
a chronic, inflammatory, multisystem disorder of the immune
system. In SLE, the body develops
antibodies that react against the person’s own normal tissue.
These antibodies are markers for SLE, and are one indicator of
many immune system
abnormalities that lead to clinical manifestations.
The course is unpredictable and individualized; no two patients
are alike. Lupus is not contagious, infectious, or malignant. It
usually develops in
young women of childbearing years, but many men and children
also develop lupus. SLE also appears in the first degree
relatives of people with lupus more often than it does in the
general population, which indicates a hereditary component.
However, most cases of SLE occur sporadically, indicating that
both genetic and environmental factors play a role in the
development of the disease.
Lupus varies greatly in severity, from mild cases requiring
minimal intervention to those in which significant and
potentially fatal damage occurs to vital organs such as the
lungs, heart, kidneys, and brain. For some patients, the disease
can be characterized by “flares” of activity interspersed with
periods of improvement or remission. A flare, or exacerbation,
is increased activity of the disease process with an increase in
physical manifestations and/or abnormal laboratory test values.
Periods
of improvement may last weeks, months, or even years. Other
patients have continuous, or chronic, activity.
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