What are the symptoms of a lupus flare-up?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 28, 2024
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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 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.

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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 Zhang Lin
Rheumatology and Immunology Nephrology
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How is lupus treated?

The treatment of lupus erythematosus mainly involves the following aspects: Firstly, mild patients can be treated with antimalarial drugs, such as chloroquine or hydroxychloroquine, thalidomide, and low-dose corticosteroids; moderate active patients can receive individualized treatment with corticosteroids, and immunosuppressants may be used when necessary; for severe patients, corticosteroids are the preferred treatment, combined with immunosuppressants such as cyclophosphamide. Secondly, for lupus crisis patients, treatment can involve immunoglobulin, high-dose corticosteroid pulse therapy. Thirdly, biologics, such as anti-CD20 monoclonal antibodies, plasmapheresis, and autologous stem cell transplantation, are also used clinically. Medication for treating lupus erythematosus should be used under the guidance of a doctor, and self-medication should be avoided to prevent serious consequences.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Is lupus contagious?

Lupus erythematosus is not contagious. The occurrence of lupus erythematosus is related to genetic factors, the levels of sex hormones in the body, and certain environmental factors that the body is exposed to. It is the combined effect of these factors that lowers the body's immune tolerance, causing disorder in immune function, and thus leading to this autoimmune disease. Therefore, unlike diseases caused by various pathogens, it cannot be transmitted from person to person. When normal individuals come into contact with patients, there is no need to fear contagion or to isolate the patients. During the remission and stable phases of the disease, lupus patients can engage in regular work, study, and participate in social activities just like healthy individuals.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if lupus causes hair loss?

What should be done when a lupus patient experiences hair loss? Patients with lupus should keep their hair clean in daily life, not use too much shampoo when washing their hair, avoid dyeing or perming their hair, and reduce the damage to hair from chemical products. This prevents rashes or worsening rashes caused by allergies to hair dyes and damage to hair quality from perming. If hair loss occurs due to the effect of medications, patients can choose to wear a wig during treatment. After chemotherapy ends, new hair will grow, so patients need not worry excessively. Maintaining a pleasant mood is also quite important for recovery from the disease. The basic pathological change in lupus patients is vasculitis. When the small blood vessels in the skin become inflamed, the nutrient supply to the hair follicles is disrupted, which can easily lead to hair loss and affect hair growth. Generally, hair can regrow after the disease is controlled. If hair loss occurs again, it could be a symptom of a disease relapse.