The Many Faces of Lupus: An Approach to the Assessment of a Lupus Patient

One of the first steps in evaluating a patient with lupus is to recognize that there are various subtypes of lupus. Determining wh ich variant of lupus in afflicting the patient will determine the extent of disease involvement and even prognosis for the patient. Certain anti-nuclear antibodies and bio markers for lupus have been shown to correlate with disease activity. Recognizing the prognostic indicators of active lupus can help guide a clin ician in choosing the appropriate pharmacologic t reat ments for their lupus patients. This clinical rev iew and summary of the literature was derived fro m med ical and online databases such as PubMed , Cochrane review, up-to-date, the American Co llege of Rheu matology and American Co llege of Physicians Visual Diagnostic Logical Imaging resources. The following is an ev idence-based, objective and balanced summation of this literature review along with the author's own rheumatologic clinical experience over the past 25 years. For the first time in decades, consensus guidelines have been established for the management of lupus nephritis. In addition, the first Food and Drug Administration-approved biologic agent, belimu mab, is now available for the treatment of certain manifestations of systemic lupus erythematosus. The reader will be able to recognize at the bedside the various subtypes of lupus, parameters of disease activity and the appropriate selection of treatment modalit ies.