How To Tell If Your Patient Is Having A Lupus Flare

Sometimes when a patient is hospitalized for new pleural effusion or pericardial effusion, it can be tough to determine if the etiology is related to their pre-existing lupus. In this video, we will briefly discuss some signs to look out for to increase or decrease your suspicion for a lupus flare. Specifically, joint pains, rash, ulcers, hair loss and various other questions on a rheumatologic review of systems, as well as serological evidence of flares like ESR/CRP, anti-dsDNA, C3 and C4 levels, etc. We will also briefly discuss the diagnosis and treatment of lupus as well. Hope it helps!

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[letticiaking]

I have lupus I like the way you detailed this video I don’t know really when I’m flareing cause I have joint pain everyday

[GatorAidMedical]

Having a good way to take a rheum HPI/ROS is critical. One thing I run into with these patients is that they're so used to not being taken seriously, is they'll say "yes" to anything during an ROS if they think it will help them get treatment?

"do your hands get cold often and turn white?" oh yeah! sure
do you have pain in your joints? yes!
do you have pain when you pee? yes!
do you frequently have blurry vision? yes!

Usually instead of this I just let them tell me their story for 5-10 mins and whatever symptoms seem to be bothering them most become my "strong" ROS positives.

living somewhere where it snows a lot, almost EVERYONE's hands get cold and white. I still don't have a good way to truly screen for raynaud's in my patients..

[katrinaluzier]

So many doctors don't take us serious even when they see the rashes and the sores and my joints are swelled up and my migraines I'm always sick always always and they just don't take it serious

[LitChick]

Thank you! I have had pleural effusions from Lupus. My score at dx was off the charts. 10 years of struggling. I appreciate your support and efforts to expand awareness 💜

[Pritzelita]

We have a practice case in med school as an M1 related to lupus and it's really cool seeing so much of what we learned from the case here!!

[TheCascadingCatalyst]

This is great but there is a serious issue around bases everything on ones ANA results when in fact it doesn’t matter if it’s positive or negative because you can still have lupus either way, and you can also have a positive or a negative result and not have lupus the important thing to me I think is just simply noticing the fact that the patient has all of the symptoms another issue I have with blood test is that there are inconsistencies and typically when I am not feeling well when my lab work would be more likely to come back abnormal that is not when I have the energy to go to the doctor or the hospital unless it’s really really bad but I’ve had bad experiences going to the emergency room for example, and being dismissed. There are a lot of issues, systemically around being able to properly recognize and diagnose lupus and listen to a patient without an assuming that they are either some sort of drug seeker or hypochondriac. I am half black and half white and I also happened to know that the doctors list me as being Caucasian and the difference in putting Caucasian versus African-American has a significant effect on the ranges of my lab results. I appreciate you making this video and I hope I shared is helpful.

[tiffanytran]

Thank you for another helpful video! Could you make a video on different types of shocks and how to manage? Thanks!

[stellar]

I have these physical symptoms for 20 years, some always, every day, some every now and then, some weekly, some every few months. My blood results were too low ( for German standards) to make the doctors do more testing. I got diagnosed with Fibromyalgia ten years ago, but it just doesn't fit properly, imo

[Aa-jiyf]

Thanks. One thing I’d add is that with the high dose steroids of 1 g daily, GI prophylaxis should be considered.