How do you counsel a patient with SLE who has labs suggesting active non-renal disease on the benefits of escalation of treatment if they aren't experiencing noticeable symptoms?

Non-renal disease is predominantly in the skin and joints. These are assessed by physical examination (not by laboratory tests). Yes, there are some patients with mild synovitis by exam who are NOT bothered by it, but most patients will have morning stiffness and require treatment. Patients who are ...

Often, it is challenging to know how best to help patients with SLE who have no clinical symptoms or findings but have serologic activity (e.g., hypocomplementemia, elevated anti-dsDNA, mild cytopenias. If these lab abnormalities are mild, chronic, and stable, it is my usual practice to observe with...

I discuss with patients that they're having active serologies but no symptoms, and that they are at risk of having a flare in the near future. I would have them on plaquenil, but anything past that, I would discuss with the patient the pros and cons of immunosuppressive therapy, and we would reach a...

I can think of several manifestations that lie in the umbrella of this question (active non-renal lupus, asymptomatic patient, could potentially cause organ damage if treatment is not escalated):

Autoimmune hemolytic anemia (AIHA), immune thrombocytopenia, and lupus hepatitis. (The asymptomatic posit...