Connected Rheumatology

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Lupus

Complements & Lupus

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If you have ever seen a Rheumatologist or there has ever been concern for lupus, you most likely have had your complement 3 (C3) and complement 4 (C4) tested. Unfortunately doctors do not do a great job of explaining these tests or their results, but are more often than not, considered when your doctor is assessing whether your lupus is “active” or “quiet.”

The complement system is complex and most doctors, aside from rheumatologists and immunologists, do not remember the specifics of the “complement cascade.” But you don’t need a PhD in immunology to have a basic understanding of how complements work and what they can teach us about our body.

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Know the facts about your dsDNA antibody

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Most lupus patients are familiar with the dsDNA antibody blood test. Like the ANA result, it is a blood test most closely related to  lupus. Occasionally a positive dsDNA result can be seen in other conditions. But, the presence of a dsDNA antibody is considered specific for a diagnosis of lupus. As there are multiple ways a lab may detect a dsDNA, there still remains the possibility of a false positive, but a positive dsDNA result warrants a trip to the rheumatologist. (Reminder = “false positive” simply means the test is positive, yet the patient doesn’t have the condition associated with that result) Patients often are referred to a rheumatologist with a notebook full of labs, mostly of all varieties of antibodies and it is overwhelming.

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Transitioning from the pediatrician’s office

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Being diagnosed with a chronic medical condition during childhood or adolescence shapes the lives of the patient and their family. In Rheumatology, the pediatric rheumatologist can become an additional parent and a partner. Pediatric hospitals and clinics become homes away from home. They are often painted bright colors, have comfy furniture and entertainment throughout the halls as everyone tries to make the heartbreaking reality of disease in children more palatable. Thankfully, treatment success in rheumatology is the norm and there will come a day in most patient’s lives when they need to say goodbye to their pediatric rheumatologist and find a new adult-focused rheumatologist. Transitioning from the pediatrician’s office is a day most patients and parents dread. This process, known as “transition,” is an integral part to any young person’s care.

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Race & Lupus: Understand the Connection

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Lupus can affect anyone. And although this is true, we do not want to ignore the fact that lupus disproportionately affects certain people. We have discussed how it affects young women, but we haven’t discussed how it affects young Black women. Lupus affects 1 in every 250 Black women and when compared to the white community, the prevalence of lupus in the Black community is 3-4x higher. It is well established that Black lupus patients tend to be sicker, need more aggressive medications and have worse outcomes. And despite the amazing advancements in testing and treatment, Black patients don’t benefit from those advances to the same extent as their white counterparts.

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Do you have common lupus symptoms?

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This is going to sound strange and I hesitate to even say it…but after 10+ years of diagnosing and caring for lupus patients, I feel like I can “smell” lupus. It’s weird, I know. But when I’m approaching a consult, whether in the clinic or in the hospital, my lupus-spidey-sense gets activated if the patient has lupus. When I teach young doctors-in-training and listen to their long list of possible diagnoses, I get excited but also impatient, waiting for them to reach the same conclusion I’ve already reached.

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