What is lupus?
Penn Medicine’s rheumatologists apply a multidisciplinary approach to the diagnosis, management and treatment of patients with systemic lupus erythematosus. Patients with lupus are among the most diagnostically and therapeutically complicated patients and often require a highly specialized team approach for optimal management.
Systemic lupus erythematosus (SLE) is a complex autoimmune disease involving the production of autoantibodies and dysregulation of the immune system. Diagnosing SLE can be challenging because every patient may present with a unique set of symptoms ranging from a mild skin rash and joint pain to severe, life-threatening disease involving many organ systems.
SLE can adversely affect cardiac, pulmonary, gastrointestinal, hematologic, renal and neurologic function in a variety of ways that have the potential to be life-threatening. SLE has been closely linked to antiphospholipid antibody syndrome which carries the risk of stroke and miscarriage; premature osteoporosis and increased fractures; and early atherosclerosis and myocardial infarctions.
Patients with SLE can be afflicted with musculoskeletal symptoms as well as chronic pain syndromes like fibromyalgia. SLE is linked to psychosocial and psychiatric difficulties that can create treatment challenges for both patients and physicians. In addition, the toxicities of the immunosuppressive medications used to treat SLE add to the complexity of balancing the risks and benefits in therapeutic decision making
Diagnosis of lupus
Accurate diagnosis of SLE requires a detailed investigation of every symptom with lab and imaging evaluation, as well as appropriate referrals to additional subspecialists. Careful assessment of the potential disease manifestations and weighing the elements of the treatment approaches are essential to providing effective care to patients with SLE. Generally, this is overseen by the rheumatologist, but frequently involves expert input from Penn Medicine’s team of nephrologists, pulmonologists, dermatologists and other specialists.
Treatment at Penn Medicine
The physicians at Penn Medicine have developed a multidisciplinary approach to achieve this concept of comprehensive care. At the center of the program is a collaborative outpatient practice shared by the divisions of renal-electrolyte and hypertension and rheumatology. As a result, lupus patients with renal disease can schedule office visits with both their nephrologist and rheumatologist on the same day.
In addition to the close cooperation of Penn Medicine nephrologists and rheumatologists, the ability of the lupus program to address the needs for multidisciplinary care rests with an extensive network of providers, including:
- Cognitive behavioral therapy
- Gastroenterology
- Hematology
- Neurology
- Ophthalmology
- Pain management
- Pain psychology
- Physical therapy
- Psychiatry
- Pulmonary
- Renal-electrolyte and hypertension
Penn Medicine is actively developing bridges to basic and translational research and participating in clinical therapeutic trials.