Larissa H. answered • 03/26/20
MSN in Family Nurse Practitioner specialty
Systemic Lupus Erythematosus (SLE) is an autoimmune disease which can have many manifestations. Most commonly seen are skin rashes and joint inflammation/pain. However, the disease can also cause insidious end organ damage to various body systems i.e. kidneys, lungs, heart, and brain. Every lupus patient will have unique manifestations of the disease which can make official diagnosis difficult. The cornerstone of stable medication therapy is hydroxychloroquine (Plaquanil) which is a medication approved for the treatment of malaria, but is used off label most commonly in lupus and rheumatoid arthritis patients. It is not well know what the mechanism of action is towards lupus, and at this point the treatment is so effective it would be unethical to do randomized controlled trials. In extreme clinical manifestations these patients are commonly hospitalized and receive high doses of corticosteroids, but the end goal is always to stabilize the disease and taper off of long term steroid use. For patients that have end organ manifestation there may be a need to add more immunosuppressive drugs. For example a lupus patient with kidney involvement would commonly take mycophenolate mofetil (CellCept) which is a medication typically given to kidney transplant patients to prevent organ rejection, but in this place it is given to tell the immune system to stop attacking itself. Medications such as Cymbalta and Lyrica are more commonly given to patients with fibromyalgia (and some others) which is not quite an autoimmune disease, but is managed by the same specialist, Rheumatology. I hope this is helpful!
