Systemic lupus erythematosus, commonly known as lupus, is a chronic autoimmune condition where the immune system mistakenly attacks healthy tissues throughout the body. This can cause widespread inflammation and tissue damage in various organs, including the skin, joints, kidneys, heart, and lungs. While lupus is a long-lasting condition with fluctuating symptoms, it is possible for individuals to experience periods where disease activity significantly reduces. This state, often referred to by patients as “dormant” lupus, is medically termed “remission.”
What “Dormant” Means for Lupus
When lupus is in remission, disease activity is minimal or entirely absent, leading to a significant reduction or disappearance of symptoms. This state can be achieved through various means, including treatment or, in rare instances, spontaneously.
Remission is not a singular, universally defined state in lupus, and it can be categorized into different levels. Complete remission implies that all lupus symptoms have vanished, and laboratory tests show no signs of disease activity, often without the need for medication. Partial remission, conversely, means that while symptoms have substantially decreased, some disease activity may still be detectable through laboratory tests, or some mild symptoms might persist.
Remission does not equate to a cure for lupus. The underlying autoimmune condition remains present, even when symptoms are absent. The disease is simply in a quiet phase, and while this can last for extended periods, there is always a possibility of symptoms returning. Objective measures, such as disease activity indices (e.g., cSLEDAI) and physician global assessments (PGA), along with blood tests, confirm remission. Symptom assessment alone can sometimes be misleading.
How Lupus Enters Remission
Achieving remission in lupus often involves a structured approach to managing the disease, primarily through medication. Healthcare providers aim to control disease activity and inflammation using various pharmacological interventions. Immunosuppressants, which work by dampening the overactive immune system, are commonly prescribed. These include medications like antimalarials (e.g., hydroxychloroquine), corticosteroids, and other immunosuppressive drugs such as mycophenolate mofetil or azathioprine.
Consistent adherence to the prescribed treatment plan is a significant factor in achieving and maintaining remission. These medications help to reduce the immune system’s attack on healthy tissues, thereby alleviating symptoms and preventing further organ damage. Newer biological therapies have also shown promise in helping patients reach remission by targeting specific components of the immune system.
While less common, some individuals with lupus may experience spontaneous remission, where disease activity decreases without specific medical intervention. This is not a predictable or common occurrence. Factors like early diagnosis and consistent medical management also influence achieving remission, enabling timely intervention and therapy adjustments.
Living with Lupus in Remission
Even when lupus is in remission, ongoing medical oversight is necessary to ensure the disease remains inactive and to detect any early signs of returning activity. Regular check-ups with a rheumatologist are standard practice, alongside periodic laboratory tests that monitor blood counts, kidney function, and inflammatory markers. This consistent monitoring helps healthcare providers confirm the sustained absence of disease activity and allows for prompt adjustments to treatment if needed.
Remission does not eliminate the possibility of future flare-ups, which are periods when lupus symptoms return or worsen. Various factors can trigger these flares, including physical or emotional stress, infections, excessive sun exposure, and even certain medications. Understanding and avoiding personal triggers, when possible, can help in prolonging the remission phase.
Maintaining some form of maintenance therapy is often important to sustain remission and prevent flares. For instance, many people in lupus remission continue to take medications like hydroxychloroquine. Lifestyle adjustments, such as a balanced diet, regular physical activity, stress management, and sun protection, support overall well-being and potentially reduce flare frequency. Living with a chronic condition like lupus, even in remission, can also have a psychological impact, with individuals sometimes experiencing anxiety about potential future flares. Support systems and mental health strategies can be beneficial in navigating these emotional aspects.