Lupus and its management

The recognition and treatment of SLE requires an approach similar to other chronic diseases. A thorough initial evaluation with regular monitoring of outwardly silent manifestations (e.g. renal) minimizes potentially devastating complications. For disease which does not threaten the patient's life or carry the threat of end-organ failure, treatment analogous to non-lupus patients is usually appropriate, including minimization of steroids. The widening use of cytotoxic agents promises to continue to decrease the mortality from SLE. These agents must be used sparingly and in consultation with a rheumatologist to reduce the incidence of infection, malignancy and sterility.