Lupus is a complex autoimmune disease that can affect various parts of the body, and its symptoms often differ from person to person. Dr. Cathy Lee Ching with Lexington Rheumatology explains, "Lupus occurs when the immune system becomes overactive and starts attacking healthy tissues instead of protecting the body. This leads to inflammation that can involve the skin, joints, kidneys, and other organs.”

In a healthy immune system, the body defends itself against viruses, bacteria, and other harmful invaders. But with lupus, this system becomes misdirected. "Instead of fighting infections, the immune system essentially turns inward," Dr. Lee Ching says. "That's why we call lupus an autoimmune disease.”

Symptoms Can Vary Widely
Lupus can affect almost any organ. The most commonly affected areas are the skin, joints, and kidneys.

Patients may develop rashes, including the well-known "butterfly rash" across the cheeks and nose. Joint pain, swelling, or stiffness is also common and may resemble arthritis. Kidney involvement can be harder to detect. "When lupus affects the kidneys, many patients don't notice symptoms until the inflammation is more advanced," Dr. Lee Ching notes. "In severe cases, people may notice swelling in the legs or around the eyes, high blood pressure, or foamy urine."

What Causes Lupus?
Lupus results from a combination of genetic predisposition and environmental triggers. Multiple genes may be involved, and while these can run in families, they don't always.

"Many people with lupus have no family history of autoimmune disease," Dr. Lee Ching explains. "Environmental triggers like infections or ultraviolet light exposure can activate the disease in someone who is genetically predisposed. But it's important to emphasize that lupus is not contagious and it's not caused by anything the patient did."

Diagnosing Lupus
There is no single test for lupus. Diagnosis requires a detailed evaluation that may include blood tests, imaging studies, biopsies, and a physical examination. "A positive ANA blood test alone is not enough to diagnose lupus," Dr. Lee Ching emphasizes. "We look at the whole clinical picture — symptoms, examination findings, labs, and sometimes input from specialists in dermatology, nephrology, neurology, or cardiology."

Because symptoms can overlap with those of other conditions, consulting a rheumatologist experienced in autoimmune diseases is essential.

Treatment Helps Calm the Immune System
Modern lupus treatment focuses on reducing inflammation and preventing long-term damage to organs. "We use medications that calm down the immune system," Dr. Lee Ching explains. Common medications may include:

• Hydroxychloroquine
• Mycophenolate
• Belimumab
• Anifrolumab

These medications often take weeks to months to take full effect. For faster relief, your doctor may prescribe glucocorticoids, such as prednisone, in the short term. "Treatment is personalized," she says. "We choose medications based on which organs are involved and how the patient responds."

Flares and Long-Term Outlook
When symptoms improve or stabilize, patients are in remission. Symptoms may return from time to time, known as flares, which can be triggered by stress, infections, surgery, or stopping medications.

"Early diagnosis and ongoing care are key to preventing damage and maintaining quality of life," Dr. Lee Ching says. "While there is no cure yet, many people with lupus live full, active lives with the right treatment and monitoring.”


Cathy Lee Ching, MD, Lexington Rheumatology