Although the young woman had experienced these symptoms for years, she had never been accurately diagnosed or educated on the complexities of the disease.
“She didn’t know about lupus comorbidities, such as heart disease, lung disease and kidney damage, that can occur if early and aggressive treatment isn’t initiated to control disease activity,” Dr. Cadet says. “She was eventually prescribed steroids, but as a young female, she didn’t anticipate the side effects, such as acne, hair loss and weight gain.”
After seeing the patient die from cardiac complications of systemic lupus erythematosus (SLE), Dr. Cadet realized how little education and support exists for many people who suffer from these debilitating rheumatic diseases.
“Some people think arthritis and autoimmune diseases only affect the joints, and while this is part of it, these diseases can also affect the heart, kidneys, eyes and many other organs,” she says. “So it’s important for patients to know about potential complications that can occur if their condition isn’t treated properly and to become familiar with treatment options.”
Studies show that if rheumatic diseases are treated early, fewer complications may occur, resulting in a longer lifespan and better quality of life. Dr. Cadet believes these individuals need coordination of care by many different specialists to address the organ systems affected.
“In rheumatology, there’s a predominance of females being affected, and many are African American, Afro Caribbean, Hispanic and Asian,” Dr. Cadet says. “So many patients come to me after being misdiagnosed by their primary care or an [emergency department] physician.”
Education Is Key
In addition to educating her patients, Dr. Cadet believes it’s important to educate primary care and emergency department physicians on symptoms that warrant a referral to a rheumatologist for further evaluation.
“It’s important for doctors to note such symptoms as extreme fatigue, photosensitivity or early cardiac symptoms that may indicate an underlying autoimmune disease,” Dr. Cadet says. “They should also check bloodwork for a low white blood cell count that persists, low platelet counts, elevated inflammation markers, and protein and blood in the urine, to ensure patients with these symptoms are referred to a rheumatologist.”
Dr. Cadet believes in treating each patient holistically, educating them not only on the importance of adhering to a medication regimen, but also discussing how lifestyle changes can positively impact their diagnosis.
“I think it’s very important for patients to stay active,” she says. “I understand it can be difficult to exercise with muscle aches or joint pain, but studies show that increased physical activity, even 15–20 minutes a day of walking or stretching, can help with flexibility of the tendons and ligaments and also strengthen bones.”
