1 / 10

Managing Fatigue in Lupus: The Doctor’s perspective

MEDICINE OF THE HIGHEST ORDER. Managing Fatigue in Lupus: The Doctor’s perspective. Jennifer H. Anolik, MD, PhD Associate Professor of Medicine Division of Allergy, Immunology & Rheumatology University of Rochester Medical Center 2010. Fatigue is common. Lupus presenting symptoms.

inigo
Télécharger la présentation

Managing Fatigue in Lupus: The Doctor’s perspective

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MEDICINE OF THE HIGHEST ORDER Managing Fatigue in Lupus: The Doctor’s perspective Jennifer H. Anolik, MD, PhD Associate Professor of Medicine Division of Allergy, Immunology & Rheumatology University of Rochester Medical Center 2010

  2. Fatigue is common Lupus presenting symptoms

  3. Lupus Diagnosis: ACR Criteria • CLINICAL • Butterfly rash (face) • Discoid rash(anywhere on body) • Photosensitivity • Oral or nasal ulcers • Arthritis • Serositis (fluid around lungs or heart) • Kidney disease • Brain disease(seizures or psychosis) • LABORATORY • Low blood cell counts (white, red, platelets) • Antinuclear antibodies • Specific autoantibodies (anti-DNA, anti-Sm, antiphospholipid) • SUPPORTING FEATURES* • Alopecia • Fatigue • Fevers • Raynaud’s Definite diagnosis of lupus: 4 of 11 criteria present

  4. Causes of fatigue • Other • Sleep disorders • Depression • Pain • Fibromyalgia • Disease activity related • Constitutional symptoms of fever, weight loss, malaise, and severe fatigue are frequently seen in active lupus • Fatigue due to anemia

  5. Is fatigue due to active lupus? • Signs and symptoms • Mild: confined to skin (rash, ulcers) and joints • Diffuse ulcerating rash • Inflammation around heart and lungs (shortness of breath, chest pain) • Inflammation in the brain • Labs/other evaluation • Low platelet or red blood cell count or white blood cell count • Kidney disease • Autoantibodies, complement levels

  6. Usually fatigue is NOT due to active lupus • LUMINA cohort- fatigue is commonly seen- 92% of patients • Increased levels of fatigue associate with presence of pain, abnormal illness-related behaviors, helplessness, fibromyalgia, depression • NOT disease activity Burgos et al., Arthritis Care and Research 2009

  7. Treatment strategies • Active disease: steroids, immunosuppressives • Other • Depression • Pain • Sleep • Fibromyalgia Tench et al., Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise, Rheumatology 2003, 42: 1050

More Related