Lupus & Autoimmune Disease Care
Lupus and Autoimmune Diseases
Our board-certified rheumatologists diagnose and treat lupus, Sjögren's syndrome, scleroderma, vasculitis, and other autoimmune conditions. We work to control flares, protect your organs, and adjust your medications over time, so you can keep working, raising a family, and living your life.
What an Autoimmune Disease Does to Your Body
Your immune system is built to attack invaders like bacteria and viruses. In an autoimmune disease, it loses the ability to tell friend from foe and begins attacking your own healthy tissue instead. Depending on which tissue it targets, that misfire can inflame your joints, your skin, your kidneys, your blood vessels, or the glands that keep your eyes and mouth moist.
Lupus, formally systemic lupus erythematosus, is the one that can reach almost anywhere. It affects the joints and skin in most patients, but it can also involve the kidneys, heart, lungs, blood cells, and nervous system. That range is exactly what makes it hard to catch. Symptoms come and go, they overlap with dozens of other conditions, and many patients spend years being told nothing is wrong.
Here is what matters. Autoimmune disease is not something you simply push through. Untreated inflammation causes damage that accumulates quietly, and by the time an organ is affected, some of that harm cannot be undone. Our rheumatologists find the disease, name it, and get it under control before it takes more from you.
How We Diagnose Lupus and Autoimmune Disease
There is no single test that says "lupus." Diagnosis is a process of assembling evidence, and it takes a specialist who has seen these patterns before. We combine a detailed history, a hands-on exam, targeted blood work, urine testing, and sometimes imaging or a biopsy.
Let's break down the blood work you may hear about. These antibody tests help point toward a specific disease, though none of them stands alone.
| Test | What It Helps Show |
|---|---|
| ANA (antinuclear antibody) | A screening test. Nearly all lupus patients test positive, but so do many healthy people, so a positive result alone does not mean lupus. |
| Anti-dsDNA and anti-Smith | Much more specific to lupus, and anti-dsDNA levels often track with disease activity and kidney involvement. |
| Anti-SSA / anti-SSB (Ro and La) | Point toward Sjögren's syndrome, and also matter in pregnancy planning. |
| Complement (C3, C4) | These proteins drop when lupus is actively flaring, so we use them to monitor disease over time. |
| ESR and CRP | General markers of inflammation in the body, useful for tracking but not specific to any one disease. |
| Urinalysis and kidney labs | Check for protein or blood in the urine, the earliest signs of lupus nephritis, which often causes no symptoms at all. |
Your physician never reads a single number in isolation. A positive ANA in a patient with no symptoms usually means nothing. The same result in a patient with joint pain, a rash, mouth ulcers, and protein in the urine means something entirely different. Reading that whole picture correctly is what a rheumatologist does.
Autoimmune Conditions We Treat
Autoimmune diseases often overlap, and many patients carry more than one. Getting the specific diagnosis right matters, because treatment and monitoring differ from one condition to the next. Our team handles the full range.
Systemic Lupus Erythematosus
The most far-reaching autoimmune disease, capable of affecting joints, skin, kidneys, heart, lungs, blood, and brain. We control flares, monitor your organs, and adjust therapy as the disease shifts over the years.
Lupus Nephritis
Kidney involvement is one of lupus's most serious complications, and it often causes no symptoms until damage is done. We screen urine and kidney function regularly and treat aggressively when it appears.
Sjögren's Syndrome
The immune system attacks the glands that make tears and saliva, causing persistent dry eyes and dry mouth, and often fatigue and joint pain. We confirm it, manage symptoms, and watch for systemic involvement.
Scleroderma
An autoimmune condition that thickens and hardens the skin and can affect the lungs, digestive tract, and blood vessels. Early recognition and monitoring make a real difference in outcomes.
Vasculitis
Inflammation of the blood vessels themselves, which can restrict blood flow and damage organs. It ranges from mild skin involvement to urgent, organ-threatening disease that needs prompt treatment.
Mixed Connective Tissue Disease
An overlap condition with features of lupus, scleroderma, and myositis at once. It needs a specialist who can sort out which components are active and treat accordingly.
Antiphospholipid Syndrome
An autoimmune clotting disorder that often travels with lupus and raises the risk of blood clots and pregnancy loss. We test for it and manage the risk directly.
Inflammatory Myositis
Autoimmune attack on the muscles, causing progressive weakness in the hips, shoulders, and neck. We diagnose it with labs, imaging, and sometimes biopsy, then treat to preserve strength.
Raynaud's Phenomenon
Fingers and toes that turn white or blue in the cold. It can be harmless on its own, but it is also an early clue to scleroderma and lupus, so it deserves evaluation.
Lupus and Autoimmune Services We Provide
Autoimmune disease is not a one-visit problem. It needs a specialist who tracks you over years, catches flares early, and adjusts treatment as your disease and your life change. Here is what we offer.
Comprehensive Autoimmune Work-Up
We assemble the full picture with a detailed history, physical exam, antibody panels, and urine and organ testing, so you get an accurate diagnosis rather than years of uncertainty.
Flare Management
When your disease becomes active, we step in quickly with the right medication at the right dose to bring inflammation down before it causes lasting damage.
In-House Infusion Center
Biologic infusion therapies such as belimumab and rituximab are delivered inside our own office in a comfortable, supervised setting, overseen by the team that already knows your case.
Organ Monitoring
We track your kidneys, blood counts, and inflammation markers on a regular schedule, because the most dangerous lupus complications often develop silently.
Medication Safety Monitoring
Immunosuppressive drugs need oversight. We monitor your labs, watch for side effects, manage infection risk, and adjust doses so you get benefit without unnecessary harm.
On-Site Clinical Trials
Lupus treatment is advancing quickly. We offer access to clinical trials of new therapies, giving qualified patients options not yet widely available.
Treatment Options We Prescribe and Manage
We match your treatment to which organs are involved, how active your disease is, and your overall health. The goal for every patient is the same: push the disease into remission, keep it there on the lowest effective dose, and protect your organs along the way. Here are the main options our rheumatologists use.
- Hydroxychloroquine (Plaquenil)
- The foundation of lupus care. It reduces flares, protects the organs, and improves long-term survival, so most lupus patients stay on it indefinitely. It requires periodic eye exams, which we help coordinate.
- Corticosteroids
- Prednisone and related steroids calm severe inflammation fast, which makes them invaluable during a flare. Because long-term use carries real costs to bone and metabolism, we work deliberately to taper you to the lowest dose possible.
- Immunosuppressants and DMARDs
- Medications such as mycophenolate, azathioprine, and methotrexate quiet the overactive immune response and serve as steroid-sparing therapy, especially when kidneys or other organs are involved.
- Biologic therapy
- Targeted infusion and injection therapies, including belimumab and rituximab, treat disease that has not responded to standard medication. These are delivered in our in-house infusion center.
- Bone, heart, and sun protection
- Autoimmune disease and its treatments raise the risk of osteoporosis and cardiovascular disease, so every plan includes bone health, blood pressure and cholesterol management, and strict sun protection for lupus patients.
We tell you why we picked a given medication, how you take it, what to watch for, and how we will track it, so you make the decision with full information rather than just filling a prescription.
When Should You See a Lupus or Autoimmune Specialist?
Autoimmune symptoms are easy to explain away. Fatigue gets blamed on stress, joint pain on age, a rash on the sun. Many patients see three or four doctors before anyone connects the dots. Book an evaluation with our rheumatologists if any of these fit you.
- Joint pain or swelling that lasts more than six weeks, especially with morning stiffness
- A butterfly-shaped rash across the cheeks and nose, or rashes that worsen in sunlight
- Deep, unexplained fatigue that rest does not fix
- Recurring low-grade fevers with no infection to explain them
- Persistent dry eyes and dry mouth
- Mouth or nose sores, hair loss, or fingers that turn white or blue in the cold
- A positive ANA test found on routine blood work
- Protein or blood in the urine, or unexplained swelling in the legs
- Recurrent miscarriages or a history of unexplained blood clots
- A family history of lupus or other autoimmune disease alongside any of the above
Next step: call us and we will evaluate you properly. Early diagnosis usually means simpler treatment and far less organ damage down the road.
Who Is at Risk, and How You Manage Life with Lupus
Who Carries the Highest Risk
Lupus overwhelmingly affects women, and most are diagnosed between the ages of 15 and 45. It is also more common and often more severe in Black, Hispanic, Asian, and Native American patients. A family history of autoimmune disease raises your odds, and sunlight, infections, certain medications, and major stress can all trigger the first flare or a later one.
How You Stay Ahead of Flares
Take your hydroxychloroquine even when you feel well, because it is quietly preventing the next flare. Protect your skin from the sun every day. Keep your appointments and your lab work, since kidney involvement is often silent. Rest when your body asks for it, stay up to date on vaccines, do not smoke, and tell us early when something changes. Pregnancy is very possible with lupus, but it should be planned with us while your disease is quiet.
Why Patients Choose Our Autoimmune Team
We take the time these cases require. Autoimmune disease is layered, and rushing it produces missed diagnoses. We sit with your history, your labs, and your symptoms rather than moving you along.
We believe you. Many of our patients arrive after years of being told their fatigue and pain were stress or anxiety. We take those symptoms seriously and investigate them properly.
We test and treat under one roof. With in-office monitoring and our own infusion center, your labs, your results, and your biologic therapy all happen in one place.
We coordinate with your other doctors. Lupus can involve nephrology, dermatology, cardiology, and obstetrics. We share notes and keep your whole care team on the same page.
We offer clinical trials when appropriate. Lupus therapy is advancing fast, and some patients qualify for newer treatments not yet widely available elsewhere.
Meet the Doctors Who Treat Lupus and Autoimmune Disease
Our physicians are board-certified rheumatologists with deep experience in lupus, connective tissue disease, and complex autoimmune care.
Gilbert F. Gelfand, M.D.
Dr. Gelfand serves as Clinical Professor of Medicine at USC and Chief of Rheumatology at Rancho Los Amigos Medical Center, and he has cared for patients for more than 30 years.
Tien-I Karleen Su, M.D., FACR
Dr. Su co-founded Amicus Arthritis and Osteoporosis Center and brings more than 10 years of rheumatology practice. As a principal investigator on numerous clinical studies, she stays close to emerging autoimmune therapies.
Susan Mansourian, M.D., FACR
Dr. Mansourian gives each patient an individual plan and helps people with complex rheumatologic and autoimmune conditions reach their best possible health outcomes.
Branden Ireifej, M.D.
Dr. Ireifej focuses on autoimmune and musculoskeletal conditions and works through an evidence-based approach with shared decision-making and patient education at every step.
Frequently Asked Questions About Lupus and Autoimmune Care
Does a positive ANA test mean I have lupus?
No. A positive ANA is common and appears in many healthy people, especially women and older adults. It is a screening test, not a diagnosis. What matters is whether you also have the symptoms, exam findings, and more specific antibodies that point to lupus. A rheumatologist reads the whole picture together.
Can lupus be cured?
Lupus cannot be cured, but it can be very well controlled. With the right treatment, most patients reach low disease activity or remission and live full lives. The key is staying on your medication, especially hydroxychloroquine, even during the stretches when you feel completely fine.
Is lupus hereditary?
Genetics play a role, and having a close relative with lupus or another autoimmune disease raises your risk. But most people with a family history never develop lupus, and most lupus patients have no affected relative. Environmental triggers matter alongside genes.
Can I get pregnant if I have lupus?
Yes, many women with lupus have healthy pregnancies. The important part is planning it with your rheumatologist while your disease is quiet, ideally stable for at least six months, and adjusting medications ahead of time. We coordinate closely with high-risk obstetrics.
Why do I need to keep taking medication when I feel fine?
Because feeling fine is often the medication working. Hydroxychloroquine in particular prevents flares and protects your organs quietly in the background. Stopping it is one of the most common reasons patients relapse, and some lupus damage, especially in the kidneys, develops without any symptoms at all.
Do I need a referral to see a lupus specialist?
It depends on your insurance. HMO plans usually require a referral from your primary care doctor, while PPO plans often let you book directly. Call our office and our staff will check your plan with you.
Do you treat patients in Spanish?
Yes. We have Spanish-speaking physicians and staff, and a Spanish-language section on our website.
Schedule an Appointment with a Lupus Specialist
You should not have to spend years searching for an answer. Whether you were just told your ANA is positive, you have been living with lupus for a decade, or you simply know something is wrong and no one has taken it seriously, our rheumatologists will listen, investigate, and build a plan.