Lupus (Systemic Lupus Erythematosus)

When To Call a Doctor

Call 911 or other emergency services immediately if you have:

• Chest pain that is crushing or squeezing, occurs with sweating or nausea, and has not been previously diagnosed.
• A sudden increase in shortness of breath that makes it very difficult for you to breathe.
• One or more of the following signs of a stroke:
  • Sudden numbness, tingling, or weakness in or an inability to move (paralysis) part or all of one side of the body (such as the face, arm, and leg)
  • Vision changes that come on suddenly, such as dimness, blurring, double vision, or loss of vision in one or both eyes
  • A seizure
  • Sudden difficulty speaking or understanding speech
  • Sudden nausea or vomiting
  • A sudden, severe headache, different from previous headaches, that occurs without a known cause
  • Sudden dizziness, clumsiness, staggering, or fainting (loss of consciousness)

Call a doctor immediately if you:

• Have chest pain.
• Are short of breath.
• Have blood in your urine or are urinating less often and in smaller amounts than usual.
• Have a fever over 100.5°F (38.1°C), with or without headache and body aches, but you haven't recently been exposed to a cold or the flu.
• Experience depression or any changes in behavior or thinking.
• Have numbness or tingling in the hands or feet.
• Are dizzy or have muscle weakness.
• Have swelling of the lower legs or feet.

Call a doctor as soon as possible if you develop any new symptoms, such as fever, aching or swollen joints, increased fatigue, loss of appetite, hair loss, skin rashes, or new sores in your mouth or nose. Also call your doctor if any symptoms that you have had for a period of time get worse.

If you have not been diagnosed with lupus and you have symptoms such as joint pain, fatigue, or skin rashes, see your doctor or tell your doctor about your concerns at your next medical appointment.

Watchful Waiting

Lupus symptoms can be very vague. However, any time that fatigue, joint or muscle pain, fever, or other symptoms develop without clear cause and persist despite home treatment, it is appropriate to call your doctor. Some of the more serious problems of lupus, including kidney and heart disease, may have no symptoms until the organs have already been damaged. Regular doctor visits are essential.

Who To See

To evaluate initial symptoms and treat mild lupus, you can consult with:

• A family medicine doctor or an internist.
• A rheumatologist.
• An immunologist.

For long-term management of complicated lupus, consult with:

• A rheumatologist.
• An immunologist.

For more complicated cases of lupus, a rheumatologist is usually the primary doctor; other specialists are consulted as needed.

• For mental health problems such as depression, anxiety, psychosis, or other behavioral changes, see your family medical doctor or internist, or a psychiatrist.
• For the treatment of organ problems, a doctor who specializes in diseases of that particular organ system may work together with a rheumatologist or immunologist. The following practitioners typically treat vital organ problems caused by lupus:
  • Cardiologist
  • Dermatologist
  • Hematologist
  • Nephrologist
  • Neurologist
  • Pulmonologist

To prepare for your appointment, see the topic Making the Most of Your Appointment

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 13, 2008
Medical Review:	Adam Husney, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine Stanford M. Shoor, MD - Rheumatology
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