Arizona’s Lupus Specialists at Summit Rheumatology
A lupus specialist’s guide to treatment and symptom management
Topic Guide
What Is Lupus?
Symptoms of Lupus
What Causes Lupus?
Diagnosing Lupus
Treating Lupus
Anti-inflammatory Diet for Lupus
What is Lupus?
Lupus is an autoimmune disease that causes widespread inflammation throughout the body, affecting the skin, joints, and organs, especially the kidneys, lungs, and brain. Lupus is chronic and occurs when the immune system attacks healthy cells and tissues. While the exact cause of lupus is unknown, lupus specialists believe that there are certain environmental triggers that can cause the immune system to begin attacking itself. There is also a genetic component to lupus: having a close family member with the disease increases your chances of developing lupus. Lupus is more prominent in women, especially women between 15 to 44, and certain racial and ethnic groups (African American, Hispanic/Latina, Pacific Islander, Native American, Asian Americans, and Alaska Natives). However, anyone can develop lupus, and the number of lupus diagnoses is continuing to rise in the United States.
Symptoms of Lupus
Lupus symptoms vary from person to person, which is one of the reasons it can be difficult to diagnose. Typically, lupus symptoms occur in flares of pain that come and go and are often triggered by stress, diet, or other environmental factors. Symptoms can affect all areas of the body, but more commonly include the following:
- Anemia
- Fatigue
Kidney problems (lupus nephritis) including high blood pressure, decreased kidney function, and swollen ankles - Fever
- Rashes, especially a red rash across the face and cheeks in a butterfly pattern
- Muscle and joint pain
- Hair loss
- Eye problems and light sensitivity
- Memory problems
- Headaches
- Mouth sores
- Chest pain
Someone with lupus may experience some or all of these symptoms. A lupus specialist will be able to go over your symptoms and determine if lupus might be the underlying cause.
What Causes a Lupus Flare?
A variety of environmental factors may cause lupus symptoms to flare. Often, prolonged exposure to the sun, exposure to certain foods, or long periods of stress can trigger inflammation that causes symptoms. What causes a flare for one person with lupus may not trigger another person’s lupus symptoms. While there are many inflammation-inducing triggers that are shared in people with lupus, environmental triggers can also be very individualized. Common triggers often include:
- Illness or virus exposure
- Ultraviolet rays (tanning beds and sun exposure)
- Certain medications (especially procainamide, hydralazine, and quinidine)
- Stress
- Diets heavy in processed foods, sugar, and dairy products
- Alcohol
- Tobacco products
Your lupus specialist may recommend keeping a symptom tracker or journal to help determine what environmental exposures could be triggering your lupus flares.
Diagnosing Lupus
If you are experiencing symptoms of lupus, your provider will likely conduct a physical examination and order tests that can help rule out other causes of your symptoms. If your provider suspects lupus, they may refer you to a rheumatologist or lupus specialist for further testing. However, you do not always need a referral to visit a lupus specialist or rheumatologist. Check with your insurance provider to determine if you require a referral.
Summit Rheumatology is a Gout Center of Excellence for the treatment and management of chronic gout.
Lab Tests for Lupus
Blood and urine tests are often the first step to a lupus diagnosis. A complete blood count (CBC) can detect if your white blood or red blood cell counts are abnormal, and an antibody blood test (ANA with double-stranded DNA) can detect antibodies in the blood that are common in people with lupus. Urine tests can identify potential kidney problems, which are common in people with lupus nephritis, as well as a comprehensive metabolic panel (CMP) to look at kidney function and liver function. However, blood and urine tests alone are usually not enough to confirm a lupus diagnosis. A kidney biopsy is very helpful for patients that have signs of kidney involvement, as this helps direct the appropriate level of treatment if the kidneys are involved.
Treating Lupus
Lupus and lupus nephritis are complex conditions that require individualized treatment to manage symptoms. Your lupus specialist will design a lupus treatment plan that manages flares, treats symptoms, and limits organ damage that can be caused by this autoimmune condition. Summit Rheumatology’s Arizona lupus specialists approach lupus treatment with a combination of medications and lifestyle modifications to better serve the individual patient at their stage of lupus.
Medications to Treat Lupus
Your lupus specialist may prescribe medications to reduce pain, decrease inflammation, and help manage secondary conditions caused by lupus.
- Corticosteroids, including prednisone help reduce swelling, rash, and lupus nephritis
- Nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen and naproxen can help manage joint pain and swelling
- Hydroxychloroquine (Plaquenil) is an important medication in lupus treatment. This medication is commonly known as an antimalarial drug, but it helps significantly with the inflammation that lupus can cause.
- Belimumab (Benlysta) is an infusion treatment for lupus that blocks certain proteins responsible for triggering an immune response. This can be combined with other medications to treat lupus nephritis.
- Mycophenolate (Cellcept) and azathioprine (Imuran) are other common medications used to treat lupus that help decrease inflammation.
There are other infusion medications that are used to treat more advanced lupus, known as Saphnelo (anifrolumab-fnia) and Rituxan (Ruxience).
Anti-inflammatory Diet for Lupus
Lupus symptoms occur from widespread inflammation throughout the body. Diet modification, including eliminating inflammation-causing foods, can help reduce inflammation and improve lupus symptoms. Top inflammation-inducing foods often include:
Dairy products (milk, cheese, ice cream) contain high levels of phosphorus. Kidney damage from lupus can cause a buildup of excess phosphorus that can damage the body and pull calcium out of the bones.
Processed foods like candy, breads, and sugary snacks may lead to additional inflammation.
Garlic activates the immune system. While garlic is a healthy choice for many, garlic may cause flares in people with autoimmune diseases, including lupus.
Alfalfa sprouts contain L-canavanine, which triggers the immune system and can cause lupus flares.
Nightshade vegetables (tomatoes, eggplant, peppers, and potatoes) trigger inflammation in some people. If you notice symptom flares after eating nightshades, you may want to consider eliminating them from your diet.
A diet consisting primarily of leafy greens, fruits, whole grains, and lean protein sources may help prevent lupus flares. If you are experiencing lupus symptoms, or are looking for a lupus specialist, Summit Rheumatology is accepting new patients. Call (480) 494-2770 or send us a message to schedule a new patient appointment.
Meet Our Lupus Specialists
Dr. Brittany Panico, DO
Chief of Rheumatology
“[Dr. Panico’s] guidance in my healthcare journey gives me great independence in my treatment...I look forward to the insight each appointment brings and am so grateful to be under her care.”
“...Dr. Panico takes the time to educate you...I know more about my condition in the 6 months I’ve been with [Dr. Panico] than I’ve understood in the 10 years with my previous practice...She is a breath of fresh air!”
W Richard Horn, NP
Rheumatology Specialist, Lupus and Fibromyalgia Specialist
“Richard Horn has been my rheumatologist since day one of being diagnosed with Lupus...He listens and [ensures] you get the answers to all of your questions... He is wonderful.”
“I’ve been seeing Richard Horn for over 10 years...He’s helped me through flares and medication changes...I highly recommend him.”
Peter Hennis, NP
Rheumatology Specialist
Peter Hennis, NP is an accredited nurse practitioner through the American College of Rheumatology. He received his degree from Case Western Reserve University and has clinical experience in the Medical and Neurological Intensive Care Units. He has a specific interest in gout, connective tissue diseases, osteoporosis, and other rheumatic conditions.
Peter has a holistic approach to treatment and values respect and dignity in his patient relationships. His ultimate goal is to help patients regain their functionality and foster education so patients can manage their autoimmune diseases with lifestyle changes.