Lupus (SLE) occurs when the immune system attacks the body's own tissues, causing inflammation in the skin, joints, kidneys, heart, lungs, brain, and blood cells. It predominantly affects women of childbearing age and follows an unpredictable course of flares and remissions. In India, lupus is underdiagnosed — many patients spend years with vague symptoms before receiving the correct diagnosis. The condition ranges from mild (skin rashes, joint pain) to life-threatening (lupus nephritis, central nervous system involvement, haemolytic anaemia). With careful monitoring and modern treatment, most patients achieve sustained remission and prevent irreversible organ damage. Dr. Atul Kakar has managed lupus patients at Sir Ganga Ram Hospital, New Delhi, for over 35 years, and has authored and contributed to several publications on autoimmune and rheumatological disease in India.
About Lupus (SLE)
When should you seek care?
How Dr. Kakar approaches treatment.
Lupus management requires careful balance: controlling disease activity while minimising side effects of immunosuppressive therapy. Dr. Kakar uses SLEDAI scoring to assess disease activity at each visit. Hydroxychloroquine is prescribed for almost all lupus patients as a long-term protective agent. More active disease is managed with corticosteroids, mycophenolate mofetil, azathioprine, or cyclophosphamide. Belimumab (biologic therapy) is available for refractory cases. Kidney involvement (nephritis) requires biopsy-guided treatment and close monitoring of urine protein and creatinine. Regular monitoring covers blood counts, complement levels (C3/C4), anti-dsDNA titres, kidney function, and blood pressure.
When to see a specialist.
See a rheumatologist promptly if you have been told your ANA is positive, if you have a combination of fatigue, joint pain, and rashes, or if you have a confirmed lupus diagnosis and are not under specialist care. Women with lupus planning pregnancy should see a rheumatologist before conception, as lupus requires specific management adjustments in pregnancy.