Can lupus patients get pregnant?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 29, 2024
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Patients with lupus can conceive normally, but it is not recommended to become pregnant. This is because patients with lupus who become pregnant are prone to miscarriage, preterm birth, stillbirth, and poor fetal development in the uterus, especially in patients who are positive for antiphospholipid antibodies. Pregnancy can also aggravate the disease or cause a relapse in lupus patients, and even if the disease is stable, there are cases where the condition worsens during pregnancy or after childbirth. Therefore, it is not recommended for patients with active systemic lupus erythematosus to become pregnant. If the condition has been stable for more than a year after treatment and the patient has been off medication for at least 6 months, then pregnancy can be considered. However, it is important to note that dexamethasone, immunosuppressants, and Tripterygium wilfordii tablets have side effects on the fetus and should be avoided.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Lupus erythematosus taking steroids side effects

Patients with lupus mainly use steroid treatment, but steroids have many side effects during their application, such as increased blood pressure, inducing or exacerbating infections, inducing or aggravating peptic ulcers, necrosis of the femoral head, osteoporosis and vertebral compressive fractures, delaying wound healing in injured patients, increasing blood sugar, etc. Additionally, steroids can cause nervous sensitivity, agitation, insomnia, emotional changes, and even apparent mental symptoms, inducing seizures such as epilepsy. Some patients may also have suicidal tendencies. Therefore, it is necessary to use medication rationally under the guidance of a doctor, reduce the dosage timely, and effectively prevent and treat to minimize the occurrence of side effects. Taking steroids can also lead to weight gain; hair loss is relatively less common. The occurrence of side effects varies among individuals and should be tailored to the patient's specific condition.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Lupus is what disease?

Lupus erythematosus, also known as systemic lupus erythematosus, is a chronic autoimmune disease involving multiple systems and organs. Patients' serum contains various autoantibodies, with the main pathological changes being inflammatory reactions and vascular abnormalities. Most patients exhibit butterfly-shaped erythema on the bridge of the nose and cheeks, which is the most characteristic manifestation of lupus erythematosus. The clinical presentations of systemic lupus erythematosus are diverse, generally characterized by the "four multiples": involvement of multiple systems, multiple organs, multiple autoantibodies, and a higher prevalence among women of childbearing age. Without proper and effective treatment, the mortality rate is high, with the main causes of death being infections, renal failure, and damage to the central nervous system.

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Written by Liu Li Ning
Rheumatology
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Do the rashes caused by lupus itch?

The erythema triggered by lupus erythematosus may or may not be itchy, varying from person to person, with each individual's condition not being entirely the same. The erythema caused by systemic lupus erythematosus also presents very differently clinically, with the typical manifestation being a butterfly-shaped erythema on the face. Other common forms include discoid erythema, reticular purpura, polymorphic rash, periungual erythema, and more. The specific pathogenic mechanism is currently unclear, and in some patients, the condition is caused by photosensitivity. After treatment, the erythema cannot completely disappear in a significant number of patients, leaving some pigment deposition. If only the skin is affected, treatment can involve the topical use of tacrolimus ointment or the oral intake of immunomodulators like hydroxychloroquine, and if necessary, oral corticosteroids may be administered.

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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 Liu Li Ning
Rheumatology
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What should I do about lupus erythematosus?

Lupus erythematosus requires early and formal treatment to stabilize the condition. For mild cutaneous lupus erythematosus, topical immunosuppressants, such as tacrolimus ointment, and immunomodulators, such as hydroxychloroquine, can be used. Low-dose corticosteroids may be necessary for combination therapy. Systemic lupus erythematosus generally requires corticosteroids as the basis of treatment, combined with one or several immunosuppressants to effectively control the disease. Systemic lupus erythematosus often involves multiple organs, with the kidneys, hematological system, and lungs being the most common. Therefore, it is necessary to use corticosteroids in combination with immunosuppressants to control the progression of the disease, as using only immunomodulators is often insufficient.