Lupus is an autoimmune disease with several forms


Dear Doctors: I was diagnosed with inactive lupus six years ago and put on Plaquenil (chemical name hydroxychloroquine). Since lupus is an autoimmune disorder, should I avoid products that may boost the immune system? Does diet play a role? I may never get rid of lupus, but I want to prevent it from becoming worse.

Dear Reader: Your questions show you have a strong grasp of what you’re facing with your lupus diagnosis.

It’s correct that lupus is an autoimmune disease. This refers to a condition that occurs when the immune system malfunctions and mistakenly attacks the body’s own tissues. Lupus is seen most often in women, who account for 90% of diagnoses. And it typically appears during the reproductive years, from about age 15 to 44.

Although the disease takes several forms, the most common is systemic lupus. That means the immune system attacks the tissues of the skin, joints and some internal organs, including the kidneys and the heart. It causes symptoms that include fatigue, exhaustion, fever, rash and painful or swollen joints.

Lupus is also chronic. It doesn’t go away. As with all long-term diseases, the goal is management. This is done by taking steps to minimize symptoms, improve quality of life and prevent unnecessary hospitalizations. For people living with lupus, this includes taking immunosuppressive medications, such as the one you’re taking; vigilant and often specialized medical care; and lifestyle changes.

Many cases of lupus are marked by alternating periods during which the disease is somewhat quiet and episodes of increased symptoms. These are known as flares. Your own diagnosis means that at this time, your symptoms remain consistently mild or even absent.

Plaquenil, also known as hydroxychloroquine, is prescribed for use in inflammatory or autoimmune diseases. It works by reducing the immune system’s ability to cause inflammation. It can help ease symptoms and reduce the occurrence of flares.

Due to a rare but potentially serious complication that involves the retina, individuals who are using this drug long-term are strongly advised to undergo a complete ophthalmologic checkup each year. This is to identify any early signs of toxicity. Be sure to let the ophthalmologist know about the drug.

Elizabeth Ko, MD and Eve Glazier, MD
We think your idea about avoiding supplements or medications that claim to boost the immune system is a good one. Your aim is to live an anti-inflammatory lifestyle. This includes taking part in regular physical activity and eating a plant-forward diet that is low in red meat, sugar and processed foods. Keep a close eye on sodium intake to help protect your kidneys.

Many people with lupus are sensitive to ultraviolet radiation, including sunlight. For some, it can trigger a flare. As a result, they avoid extended exposure. This makes it possible to become deficient in vitamin D. Your doctor can tell you if you’re getting enough vitamin D through fortified foods, and whether a supplement may be needed.

Lupus flares can also be triggered by stress, overwork and not enough rest, so make your mental and emotional health a priority. Yoga, meditation, tai chi and mindfulness exercises are all helpful.

UCLA Health Rheumatologists are experts in diagnosing and treating joint conditions, autoimmune diseases and connective tissue disorders. Learn more and schedule an appointment.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)