Can lupus be treated without steroids?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 13, 2024
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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.

Other Voices

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Written by Liu Li Ning
Rheumatology
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What is lupus and is it serious?

Lupus erythematosus is an autoimmune disease, which can be very severe in some cases and mild in others. For example, cutaneous lupus erythematosus generally does not involve major organs and usually presents with mild symptoms, primarily affecting the skin and mucous membranes. However, systemic lupus erythematosus can affect significant organs like the kidneys and heart in many patients, often leading to severe medical conditions. Especially, patients with rapidly progressive glomerulonephritis and those with coronary atherosclerotic heart disease tend to have a higher mortality rate. If systemic lupus erythematosus is diagnosed, it is crucial to receive standardized treatment early. Typically, treatment involves long-term maintenance with corticosteroids and immunosuppressants to control the progression of the disease and reduce the likelihood of mortality.

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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 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 Liu Li Ning
Rheumatology
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Symptoms of lupus cerebritis

Symptoms of lupus cerebritis can range from mild to severe. Mild symptoms include migraines, personality changes, memory loss, or mild cognitive impairment. Severe cases may present with cerebrovascular accidents, coma, status epilepticus, and other central nervous system symptoms, including aseptic meningitis, cerebrovascular disease, demyelinating syndrome, headaches, movement disorders, spinal cord disease, epileptic seizures, acute mental confusion, anxiety, cognitive impairment, mood disturbances, and psychiatric disorders. Peripheral nervous system manifestations include Guillain-Barre syndrome, autonomic dysfunction, mononeuritis, myasthenia gravis, cranial nerve disorders, nerve plexus disorders, and polyneuritis.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Does lupus cause itchy skin?

The rash in patients with lupus erythematosus is generally not noticeably itchy. In patients with lupus erythematosus, the characteristic changes include a butterfly-shaped rash on the bridge of the nose and cheeks. The skin lesions of lupus erythematosus include photosensitivity, hair loss, erythema on the palms and soles and around the nails, discoid lupus, nodular erythematosus, seborrheic dermatitis, livedo reticularis, and Raynaud's phenomenon, among others. Generally, there is no noticeable itching. If significant itching occurs, it suggests an allergy. Itchy rash after immunosuppressive treatment should be monitored for fungal infections. Lupus patients receiving steroid and immunosuppressive therapy, if experiencing unexplained localized skin burning, may be showing early signs of herpes zoster and should seek prompt medical attention at a hospital.