Dr. Fatemeh Ezzati on Systemic Lupus Erythematosus

Dallas rheumatologist and autoimmune disease specialist Dr. Fatemeh Ezzati answers questions about systemic lupus erythematosus (SLE).

What’s the difference between systemic lupus erythematosus (SLE) and other forms of lupus?

Lupus can take multiple forms with the most common forms including skin lupus, which is limited to the skin and doesn’t usually develop into systemic lupus; drug-induced lupus, in which the symptoms are caused by a medication and go away when the drug is removed; and SLE, a chronic illness that can involve any organ in the body.

Is it safe for a woman with systemic lupus to have a baby?

In the past, pregnancy was considered risky for women with SLE, but today pregnancy is a viable option—you just need to have a good team of doctors, including a rheumatologist, and frequent monitoring and follow-up. Having lupus can affect fertility and increase the risk of miscarriage, but with frequent follow-up the chances of safely getting pregnant and having healthy pregnancies and healthy babies are very promising.

Why do women get SLE more frequently than men?

The causes of lupus and the reasons why some people are more at risk than others are still unclear. We believe it is a mix of genetic, hormonal, and environmental factors. But it’s a very common misconception to believe that lupus is only a women’s disease. While lupus is certainly much more common in women—up to 10 times more common—men can still get lupus.

If I have a butterfly rash on my face, does that mean I might have SLE?

The butterfly rash is not a definitive sign of lupus. A patient with lupus may never get it, and a patient without lupus may get such a rash.

Biologics are a new class of drugs that have helped many people with systemic lupus. Are they effective for everyone with SLE?

For now, the biologics are widely approved for patients who have mainly joint and skin involvement. Those medications haven’t yet been approved for involvement of the kidneys or the brain and nervous system—previous studies have shown that there is no added benefit for those patients. But we are doing more studies with more drugs, including clinical trials here at UT Southwestern, and we are optimistic about new medications that will be effective for patients with lupus that involves the kidneys and other organs in the body.