1. Treatment
   1. NSAID's
      1. Reduces inflammation and pain in muscles, joints, and other tissues
      2. Include: Aspirin, Ibuprofen, Naproxen, Sulindac, etc.
   2. Corticosteroids
      1. More potent antiinflammatory medications
      2. Used during flare-ups or when internal organs are affected
      3. Side effects of corticosteroids include weight gain, thinning of the bones and skin, infection, diabetes, facial puffiness, cataracts, and death (necrosis) of the tissues in large joints
   3. Anti-malarial drugs
      1. Hydroxychloroquine, chloroquine, quinacrine
      2. Used to prevent flare-ups
      3. Side effects are uncommon but include diarrhea, upset stomach, and (rare) eye-pigment changes
   4. Immunosuppressant drugs
      1. Cytotoxic drugs including methotrexate, azathioprine, cyclophosphamide, chlorambucil, and cyclosporine
      2. Used for treating patients with more severe manifestations of SLE, such as internal organ damage
      3. Immunosuppressive medications can seriously depress blood-cell counts and increase risks of infection and bleeding
2. Etiology
   1. Genetic
      1. Inherited predisposition to autoimmune disorders
         1. Several family members have autoimmune disorders
   2. Environmental
      1. Drugs
      2. Extreme stress
         1. Had flare when experiencing stress from flying
      3. Ultraviolet light
         1. Developed rash from sun exposure
   3. Hormonal
      1. More commonly effects women
         1. Patient is female
3. Diagnosis
   1. Malar "butterfly" rash on face
   2. Discoid skin rash
      1. Patchy redness with hyperpigmentation and hypopigmentation that can cause scarring
   3. Photosensitivity
      1. Skin rash in reaction to UV exposure
         1. Biopsy found vasculitis (WBC's in blood vessel walls)
   4. Mucous membrane ulcers
      1. Spontaneous ulcers of the lining of the mouth, nose, or throat
   5. Arthritis
      1. Two or more swollen, tender joints of the extremities
   6. Pleuritis or pericarditis
      1. Inflammation of the lining tissue around the heart or lungs, usually associated with chest pain upon breathing or changes of body position
   7. Kidney abnormalities
      1. Abnormal amounts of urine protein or clumps of cellular elements called casts detectable with a urinalysis
   8. Brain irritation
      1. Manifested by seizures [convulsions] and/or psychosis
   9. Blood-count abnormalities
      1. Low counts of white or red blood cells, or platelets, on routine blood testing
   10. Immunologic disorder
       1. Abnormal immune tests include anti-DNA or anti-Sm [Smith] antibodies, falsely positive blood test for syphilis, anticardiolipin antibodies, lupus anticoagulant, or positive LE prep test
   11. Antinuclear antibody
       1. Positive ANA antibody testing [antinuclear antibodies in the blood]
4. Signs & Symptoms
   1. Fatigue
   2. Low grade fever
   3. Loss of appetite
      1. Patient experienced significant weight loss
   4. Arthritis
      1. Joint imflammation
   5. Myalgia
      1. Muscle Aches
   6. Ulcers of the mouth and nose
   7. Facial rash (malar)
   8. Photosensitivity (sunlight)
   9. Pleuritis
      1. Inflammation of pleura (lungs)
   10. Pericarditis
       1. Inflammation of pericardium
          1. Pulmonary edema
   11. Raynaud's Phenomenon
       1. Poor circulation to fingers and toes with cold exposure
   12. Alopecia (hair loss)
   13. Jaundice
   14. Lymphadema