Can lupus be inherited?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 28, 2024
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Lupus erythematosus is not a genetic disease, but it is a disease with a genetic predisposition. This means that genetic diseases refer to monogenic diseases, including albinism, color blindness, etc., which are determined by a pair of alleles. However, lupus erythematosus is a disease with a genetic predisposition, determined by multiple genes. Although lupus erythematosus is not a genetic disease, if your parents have lupus erythematosus, the chance of the next generation developing lupus erythematosus is about 1% to 16%. This relationship is especially significant between mothers and daughters, and among sisters. Genetic factors account for approximately 20% of the importance in the development of lupus erythematosus. Only the combination of genetic factors and environmental factors together can lead to the occurrence of lupus erythematosus.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What are the symptoms of a lupus flare-up?

After treatment with steroids and other therapies, active lupus erythematosus usually improves and enters a stable phase. However, factors such as infection, pregnancy, surgery, fatigue, and discontinuation of medication can trigger the transition from a stable phase back to an active phase of lupus erythematosus. The following symptoms should be considered for a possible recurrence of the disease: First, onset of fever without reasons related to colds or infections. Second, appearance of new rashes or vascular-like rashes on fingertips and other areas. Third, recurrence of joint swelling and pain. Fourth, significant hair loss. Fifth, development of fresh ulcers in the mouth or nose. Sixth, development of fluid accumulation in the chest cavity or pericardium. Seventh, increased protein in urine, decrease in white blood cells or platelets, or significant anemia.

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Written by Liu Li Ning
Rheumatology
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Where does lupus erythematosus generally appear?

Lupus erythematosus can appear on various parts of the body. The most typical rash is the butterfly rash on the face, but it can also appear on other parts, such as discoid lupus, annular erythema, periungual erythema, and livedo reticularis. Additionally, systemic lupus erythematosus affects not only the skin and mucosa but can also involve the lungs, kidneys, heart, central nervous system, and other systems. Common manifestations include lupus nephritis and lupus pneumonia. The precise pathogenesis of systemic lupus erythematosus is still unclear. If the damage is confined to the skin and mucosa, immunomodulators such as hydroxychloroquine can be used for treatment. If important organs are involved, it generally requires long-term maintenance treatment with corticosteroids combined with immunosuppressants to control the progression of the disease.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if I have a fever with lupus erythematosus?

When patients with lupus experience fever, the fundamental approach is the use of ample steroids or other immunosuppressive drugs for treatment, which generally can quickly normalize body temperature. However, some patients may also experience fever during steroid use, possibly due to the steroids reducing immune function and inducing a bacterial infection. At this point, it is necessary to find evidence of infection and promptly treat with adequate sensitive antibiotics. Then, there will certainly be questions about why patients with lupus who have a fever cannot use antibacterial drugs or antipyretics. This is because fever in lupus patients is often an important indicator of disease activity. During acute phases, the fever is typically high, not caused by external infections, thus antibacterial drugs are ineffective. Using antipyretics can temporarily normalize body temperature, but once the effect of the medication wears off, the high fever may recur. Patients with lupus should not casually use medications. If medication is needed, it should be used under the guidance of a doctor.

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Written by Yan Xin Liang
Pediatrics
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Symptoms of childhood lupus

Childhood systemic lupus erythematosus generally presents similarly to adults. It is a relatively common systemic autoimmune disease, more commonly seen in girls than boys. It involves multiple autoantibodies primarily including antinuclear antibodies and widespread small arteriole pathology, affecting multiple systems. Clinically, it can manifest with fever, skin lesions, such as butterfly rash on the face, as well as damage to the joints, kidneys, liver, heart, serous membranes, and a reduction in all blood cells. Generally, the ratio of females to males ranges from about 6:1 to 9:1. The prognosis of this disease is generally poor.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus be treated without steroids?

Hormones are currently the first choice of drugs for treating lupus erythematosus, and there are no other drugs that can replace them temporarily, so we still recommend using hormones for treatment. Hormones can quickly and effectively suppress the immune response, reducing the damage to the patient's body from the inflammatory substances released during the immune response. This kind of immune-suppressive and anti-inflammatory action is a protective therapeutic effect on the body. Although long-term use of large doses of hormones has certain side effects, it can quickly block the development of the disease and alleviate the condition. The function of hormones cannot be replaced by any other drug at present, so, no matter what stage the lupus erythematosus patients are in and regardless of the type of damage, hormones are the first choice of drugs. Hormones have many side effects, therefore, we need to use hormone drugs for treatment rationally and standardized under the guidance of a doctor, and should not take them arbitrarily to avoid serious consequences.