Lupus Flares: Recognizing one, triggers, and prevention

What is lupus? 

Lupus  is a very long name for a very complicated disease that is more commonly known as SLE or lupus.  Lupus is a widespread and chronic (lifelong) autoimmune disease that, for unknown reasons, causes the immune system to attack the body’s own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood, or skin.  SLE can affect nearly every organ system in the body. The skin is no exception, and in fact, may be involved in 70-80% of cases, causing sores, ulcers and/or rashes. Because lupus is a multi-symptom disease, it can take years to properly diagnose.  Lupus is considered a connective tissue disease and will often “overlap” with other such connective tissue diseases such as scleroderma, dermatomyositis, rheumatoid arthritis, and Sjogren’s syndrome.

What is a lupus flare and how do I recognize one?

Unpredictable and debilitating bouts with symptoms of the disease are known as flares.

At times lupus patients may have periods with few to no symptoms, commonly called remissions. Some physicians are uncomfortable with the term “remission” as lupus symptoms rarely disappear completely.  They may, instead, choose to use the term “quiescence” (pronounced: kwee-ess-ence.) At other times the patient may have high disease activity which include unpredictable and debilitating bouts with symptoms of the disease.

Flares can be classified as mild, moderate, or severe. For example: A mild flare could perhaps be signaled by a lupus rash, moderate flares could include the rash, fatigue, and joint or muscle pain, and severe flares could potentially cause damage to the organs including fluid buildup around the heart or even kidney disease or failure (called lupus nephritis), which would require immediate medical attention.

So how is a lupus flare recognized?

Most lupus patients will have symptoms of muscle and joint pain as well as fatigue regularly, so what makes a flare different? Here are some warning signs of a pending lupus flare:

*It is important to report any of these with your medical caregiver as soon as possible so that they can quickly assess and treat any symptoms that could signal a flare. Keeping a daily symptom journal can be a helpful tool.

What can trigger a lupus flare?

Lupus is an auto-immune disease. This means that the immune system, when activated, creates auto-antibodies that attack not only an invading virus, but will turn and continue to attack healthy cells and organs, thus causing inflammation. Therefore, anything that stimulates activity in the immune system can cause a lupus flare. Here is a list of potential flare triggers:

Can anything prevent a lupus flare?

*The anitimalarial drug Plaquenil (hydroxychloroquine), a very commonly prescribed lupus medication, has been shown to prevent lupus flares. It is very common for patients, who are having no symptoms, to feel as thought they are better and stop taking their medications without first consulting their physician. This is very dangerous. Stopping a prescribed medication like Plaquenil could feasibly cause a flare. Again, please speak clearly and often with your medical caregiver about any and all medication decisions. Ask as many questions as you need to make sure you feel comfortable and have a clear understanding of what you are taking and why.

Be sure to make any new caregiver aware that you have lupus before they prescribe any medications. This is also relevant advice when considering receiving any immunizations.

Your physician has probably created a specific plan of treatment that was created specifically for you and your lupus symptoms. The most important thing is for you to completely understand this plan and the steps needed to keep your disease under control and avoid a lupus flare. Your plan may include some or all of the following:

• Take your prescribed medications as indicated by your physician
• Physical and emotional rest
• Aggressive treatment of infections
• Exercise
• Good nutrition
• Avoidance of direct sunlight and other sources of ultraviolet light, see our blog on photosensitivity.
• Watch for stress. Having a chronic illness can understandably cause anxiety and depression which can lead to stress.  Finding ways to manage stress is very important. This is often called a mind/body balance.

Sometimes, despite you and your medical caregiver’s best attempts, you may still experience a lupus flare. If you suspect that you are having a flare, please contact your physician immediately so that any adjustments to your treatment plan and medications can be made.

We hope that this has been an informative and helpful blog. If you think so, please share it with your social networks or pin any of the above images to Pinterest by clicking on the icons below.  Together we can spread lupus information and awareness.