Lupus

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Rheumatology specialists at the Duke Lupus Clinic are committed to enhancing the lives of people with lupus. Lupus is a complex autoimmune disease that can cause inflammation in many different parts of the body. Our rheumatology program is renowned for its research, approach to care, and treatment of lupus. We use innovative approaches to manage your disease and improve your quality of life.

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About Lupus

Lupus is a chronic autoimmune disease in which the immune system attacks healthy tissues in the body. It can vary in severity and cause many symptoms, such as swollen joints, skin rashes, kidney inflammation, fatigue, fever, and pain. Lupus is best diagnosed and managed by a specialist.

Our Approach to Lupus

Duke rheumatologists follow a categorization system that splits lupus into two types (Type 1 and Type 2) based on your symptoms. This helps us provide more specialized care, using treatments that are tailored to you and your type of lupus.

Type 1:

Includes swollen and painful joints, and impacts the kidney, heart, lungs, or skin.
Caused by autoimmune inflammation in the body.

Type 2:

Includes fatigue, pain, brain fog, and trouble sleeping.
Sometimes caused by inflammation as well as other physical, emotional, psychological, and social factors.

Our experienced rheumatologists have the skills and tools to make an accurate diagnosis and outline a comprehensive treatment plan. We work with you and other specialists across Duke to help you manage the effects of lupus on your body’s multiple systems and organs.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Lupus Treatments

We strive to help you manage the full spectrum of lupus, allowing you to participate in the activities you enjoy. Your treatments options may include:

Hydroxychloroquine (Plaquenil)

Decreases the risk of lupus flares, progressive renal disease, and death from lupus. It is often the first medication we use to treat the disease. Hydroxychloroquine also helps relieve lupus symptoms such as skin rashes, joint pain, and mouth sores.

Prednisone

This steroid reduces swelling and inflammation. Because prednisone can cause side effects, we try to use it at the lowest dose and for the shortest amount of time while we find alternative immune medications and therapies to treat lupus and decrease the long-term use of steroids.

Immune-Suppressing Drugs

Drugs that lower the body’s overactive immune response can help treat inflammatory lupus symptoms. Depending on the specific medication, these immune-suppressing drugs can help relieve symptoms such as arthritis; rash; and kidney, lung, and heart inflammation.

Methotrexate
Azathioprine (Imuran)
Mycophenolate mofetil (Cellcept or Myfortic)
Cyclophosphamide (Cytoxan)
Belimumab (Benlysta)
Anifrolumab (Saphenlo)
Voclosporin (Lupkynis)
Rituxan (Rituximab)

Physical Therapy

Aquatic exercise, biking, walking, and stretching can help relieve the pain and fatigue associated with lupus. Physical activity can decrease the long-term cardiovascular risk associated with lupus.

Psychological Counseling

Chronic pain, depression, anxiety, and sleep problems are common among patients with lupus. Psychological counseling, cognitive behavioral, or acceptance and commitment therapy can be a valuable way to help manage chronic symptoms. We collaborate with therapists, psychologists, and psychiatrists to develop the best plan for your care.

New Patient Appointment

855-855-6484

Tests for Lupus

Lupus is diagnosed by using a combination of laboratory tests, medical history, and a comprehensive physical exam. Your evaluation -- which may require multiple visits -- may include:

Blood and Urine Tests

Your doctor will order blood and urine tests to check blood counts, identify kidney and liver function, and search for lupus antibodies and markers of lupus activity. People with lupus often have abnormal blood counts, elevated autoantibodies, and low complement levels.

Biopsy

Depending on your lupus symptoms and lab testing, you may be referred to a nephrologist or dermatologist to take a small sample of kidney tissue or skin to confirm your diagnosis.

Other Tests

You may undergo radiology, ultrasound, or breathing tests to help your doctor better understand and manage your disease. Imaging tests may include X-rays, CT scans, echocardiograms, or pulmonary function tests.

High-Performing Hospital for Rheumatology in the U.S.

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our rheumatology program is rated as high-performing among the nation's top hospitals, according to US News & World Report for 2024–2025.

Expert Lupus Care

Comprehensive, Coordinated Care
We have a robust network of subspecialists who play a key role in managing the many aspects of systemic lupus erythematosus (SLE). We collaborate with dermatology, nephrology, hematology, pulmonology, cardiology, obstetrics/gynecology, psychiatry, and neurology to provide a comprehensive, patient-centered approach to your care. This multidisciplinary approach ensures that every aspect of your lupus is addressed with specialized expertise, allowing us to deliver tailored, holistic care to our patients.

Specialized Care Before and During Pregnancy
We are one of the few centers in the nation to offer care focused on women with lupus who are pregnant or plan to become pregnant. We work closely with Duke’s high-risk maternal fetal medicine specialists to safely coordinate medications during pregnancy. By providing individualized treatment plans and collaborating with maternal fetal medicine specialists, we strive to ensure optimal health outcomes for both women with lupus and their babies.

Giving Back: Lupus Research at Duke
As leaders in lupus research, the Duke Lupus Research Team strives to advance knowledge about lupus and improve care for those living with lupus. Our research is patient-centered, incorporating your voices and experiences to enhance understanding.

Duke Lupus Registry and Biorepository
Our research program includes the Duke Lupus Registry, which is a detailed clinical registry about lupus and is the basis for several clinical and translational research projects. It includes detailed clinical information from over 500 participants. The goal of the registry is to understand the impact of lupus, gain new knowledge about lupus, and establish best practices for caring for people living with lupus. All Duke Lupus Clinic patients are welcome to participate in the Duke Lupus Registry. You may be eligible to participate in other lupus-specific clinical trials, or observational registries that test new therapies for lupus.

Patient Resources

Lupus and Pregnancy

This page was medically reviewed on 04/29/2025 by

Jennifer L. Rogers, MD | Rheumatologist