Lupus (SLE)

What is lupus?

Lupus (SLE) is an autoimmune disease in which the immune system produces antibodies that attack the body's own healthy tissue. It can affect virtually any organ system — leading to inflammation and damage in the joints, skin, kidneys, brain, heart, and lungs. It is characterised by flares and remissions.

Lupus is notoriously difficult to diagnose — the average time from first symptoms to diagnosis is six years. Symptoms are highly variable between individuals, and many early features (fatigue, joint pain, skin rash) are common to many other conditions. A combination of clinical assessment and specific blood tests (ANA, anti-dsDNA antibodies) is needed to confirm the diagnosis.

Symptoms

• Butterfly rash — a characteristic red rash across the cheeks and nose, often triggered by sun exposure
• Joint pain, swelling, and stiffness — typically in small joints, moving between different joints
• Extreme fatigue — often the most disabling symptom
• Photosensitivity — skin that is unusually sensitive to sunlight
• Mouth ulcers
• Hair loss during flares
• Raynaud's phenomenon — fingers turning white or blue in cold
• Pleuritis or pericarditis — chest pain from inflammation of the lung or heart lining
• Kidney involvement — detected through blood and urine tests; may have no symptoms early on

Causes

Lupus is caused by a combination of genetic susceptibility and environmental triggers. It is significantly more common in women — particularly those of childbearing age — and in people of African, Caribbean, and Asian descent. Triggers for flares include UV light exposure, infections, stress, and certain medications.

When to see a doctor

See a doctor if you have a combination of unexplained fatigue, joint pain, skin rashes, and sun sensitivity — particularly if you are a woman under 50. People already diagnosed with lupus should maintain regular monitoring appointments to detect and treat organ involvement before it causes irreversible damage.

Treatment options

• Hydroxychloroquine — taken by almost all lupus patients; reduces flare frequency and severity and protects against organ damage long-term
• NSAIDs — for joint pain and inflammation during flares
• Corticosteroids — for acute flares and organ involvement
• Immunosuppressants (azathioprine, mycophenolate, methotrexate) — for moderate to severe disease
• Biologics (belimumab, anifrolumab) — for cases not controlled by conventional treatment
• Sun protection — essential to prevent skin flares and photosensitivity reactions
• Regular monitoring — blood and urine tests to detect kidney, blood, and organ involvement

How eMedClinic can help

Our rheumatologists provide lupus assessments, arrange diagnostic blood tests, prescribe hydroxychloroquine and other medications, and support ongoing monitoring. We are particularly well placed to help expats who have moved abroad and need to re-establish their lupus care without gaps in treatment or monitoring.