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Systemic lupus erythematosus, commonly known as lupus, is a complex autoimmune disease. It occurs due to a malfunction in the body's immune system, causing immune cells and substances to attack various organs, including the skin, kidneys, nerves, heart, lungs, musculoskeletal system, blood system, and immune system. Symptoms vary depending on the location and nature of these immune attacks.
One demographic group is particularly prone to lupus: young women in their 20s and 40s. There is a reason for this. “Lupus is more common in women in this age group and tends to worsen because female hormones stimulate the body’s autoimmunity,” said Jung Ju-yang, professor of rheumatology at Ajou University Hospital, on the hospital's YouTube channel. "It is about nine times more common in women than in men."
(Credit: Getty Images)
(Credit: Getty Images)
Even with the most advanced diagnostic technology, lupus remains difficult to diagnose, often leading to a preliminary diagnosis of “pseudo-lupus.” “Many people visit the rheumatology department after testing positive for autoantibodies. Normally, these should not be present, but if they are, we need to determine whether the patient has an autoimmune disease like lupus,” said Jung.
"Some people have autoantibodies but no inflammation, while others exhibit only one or two lupus symptoms. These cases are classified as 'pseudo-lupus' rather than a definitive lupus diagnosis," Jung said. She emphasized that patients diagnosed with pseudo-lupus should consult a rheumatologist to assess whether ongoing monitoring is necessary.
In recent years, advances in treatment have enabled a small percentage of lupus patients to discontinue their medications. However, the primary goal of lupus treatment remains management rather than a cure. Why is that?
"Even if inflammation is well controlled and symptoms improve, they can flare up and worsen over time or with a reduction in medication," Jung said. "The most important thing is to stay on the medication and maintain remission, where the disease improves, symptoms subside, and stability is achieved."
A variety of medications are available to treat lupus, including non-steroidal anti-inflammatory drugs, steroids, immunosuppressants, and biologics. But what determines the choice of treatment?
"Since each lupus patient has different symptoms, affected tissues, and levels of inflammation, we determine the appropriate steroid dosage, type of immunosuppressant, and other treatments based on the location and severity of the inflammation," explains Jung.
Even among lupus patients, the medications prescribed vary depending on their symptoms and the organs affected. If there is a risk of permanent damage, such as nephritis or vasculitis, high doses of steroids and immunosuppressants are required. However, for conditions like skin rashes or arthritis, treatment typically includes the antimalarial drug hydroxychloroquine, low doses of steroids, and non-steroidal anti-inflammatory drugs, according to Jung.
Lupus is a lifelong disease, so how can it be managed effectively? "Lupus is a chronic condition that fluctuates between periods of worsening and improvement, making it crucial to keep inflammation under control and prevent flare-ups," says Jung. "Another key aspect of management is responding quickly to exacerbations. If a fever persists, it is advisable to visit a hospital for appropriate treatment."
Using sunscreen is also essential, as ultraviolet rays can aggravate lupus. "Since sunscreen use can reduce vitamin D production, leading to deficiency, taking vitamin D supplements is recommended," says Jung. "Maintaining a balanced diet for proper nutrition and engaging in moderate exercise to preserve muscle strength are also important aspects of lupus management," she adds. "Lupus is not difficult to treat, and with proper management, it can be well controlled."
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Kim Kyoung-Won kkw97@docdocdoc.co.kr
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