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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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 Li Jing
Rheumatology
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What causes lupus erythematosus?

Firstly, systemic lupus erythematosus is a chronic, multi-systemic, systemic autoimmune disease that commonly occurs in women of childbearing age, more frequently seen in females, with a significantly higher incidence rate in females than in males. The cause is currently unclear, only indicating that experts believe it is related to environmental pollution, viral infections, hormone levels, genetics, etc., but there is no definitive evidence proving which factors it is related to, only stating that there are studies linking it to these factors. Its clinical manifestations also vary, with most cases having a gradual onset, characterized by recurrent erythema, even pustules, Raynaud's phenomenon, etc. A minority of patients may have a sudden onset, primarily presenting with major hematologic damage.

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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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Can lupus patients get pregnant?

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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What foods are good for lupus erythematosus?

The diet for patients with lupus erythematosus varies from person to person. Generally, the ideal food for lupus patients should have the following characteristics: an appropriate amount of high-quality protein, low fat, low salt, low sugar, and rich in vitamins and calcium. Since many lupus patients often have significant kidney damage, proteins are frequently lost in large amounts through the urine, causing hypoalbuminemia and edema. The supplementation of protein should primarily consist of high-quality animal proteins, such as milk, eggs, and lean meats. However, protein intake should also be appropriate and not excessive. Excessive intake can not only lead to incomplete absorption by the patient, increasing the burden on the gastrointestinal tract, but also increase the excretion of nitrogenous compounds in the body, further burdening the kidneys. Lupus patients should avoid or minimize consumption of foods that can enhance photosensitivity, such as figs, rapeseed, cilantro, and celery. If consumed, they should avoid sun exposure afterwards. Mushrooms, smoked foods, and certain food dyes can also trigger lupus and should be avoided or minimized in the diet.