Early Red Flags

• Recurrent joint pain and fatigue.
• Photosensitive rash.
• Proteinuria or unexplained haematuria.
• Unexplained fevers or neurological issues.

Recommended Workup

• ANA, anti-dsDNA, anti-Smith, complement levels.
• ESR, CRP for inflammation.
• Urinalysis and renal biopsy for lupus nephritis.
• Imaging for organ involvement.

Clinical Classification

Based on 2019 EULAR/ACR criteria:

• ANA ≥1:80 plus clinical/immunological points.
• Score ≥10 → classified as lupus.

Management Approach

• Mild disease: NSAIDs, hydroxychloroquine, topical steroids.
• Moderate disease: Corticosteroids and immunosuppressants.
• Severe disease: High-dose steroids, cyclophosphamide, or biologics.

Monitoring & Long-Term Care

• Renal function (creatinine, urine tests).
• Cardiac and pulmonary monitoring.
• Bone density (long-term steroid use).
• Infection risk in immunosuppressed patients.
• Reproductive counselling for women of childbearing age.

Special Considerations

• Pregnancy: High-risk; hydroxychloroquine is safe, cyclophosphamide should be avoided.
• Cardiovascular risk: 2–10× higher; routine screening is needed.
• Vaccinations: Inactivated vaccines encouraged; avoid live vaccines if immunosuppressed.

Quick Checklist for Doctors

• Think lupus in unexplained multi-system symptoms.
• Start hydroxychloroquine early.
• Use steroids carefully and taper quickly.
• Always check renal and CNS involvement.
• Encourage multidisciplinary care.