(dailyRx)

Rheumatologists more often follow the American College of Rheumatology's guidelines for treating lupus.

A Norwegian study does not say non-rheumatologists provide bad care. Instead, the study found that rheumatologists more often test for antiphospholipid antibodies (aPL) and prescribe hydroxychloroquine (HCQ). Treatment guidelines developed by the specialists' organization, the American College of Rheumatology, recommend both actions for many patients.

Diagnosing lupus-like diseases can be difficult. Don't get discouraged.

Rheumatologists test 94 percent of their patients for aPLs, compared to 68 percent of other specialists' patients. The blood test is important because the presence of aPL indicates a risk of blood clots, says rheumatologist Karoline Lerang, who researches at Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Almost 80 percent of rheumatologists' patients receive HCQ, compared to the other group's 12 percent.

The study analyzed 325 lupus patients treated between 1999 and 2008. Rheumatologists provided the only care for 227 patients. For 34 patients, care came only from non-rheumatologists such as nephrologists, hematologists or infectious disease specialists.

Rheumatologists and other specialists jointly cared for 64 patients in a third group.

Would the results from Norway apply to medical care in the U.S.? The study did not cover that question, but other research provides a clue.

Some U.S. studies have shown that patients with some other diseases, such as asthma and allergy, often have better outcomes if a specialist, such as an allergist, provides the care.

Dr. LeRang's observational study appeared in Rheumatology.

Lupus

Close to 200,000 people in the United States have lupus, with women being affected nine times more than men. Lupus is an autoimmune disease that attacks multiple organ systems and connective tissues in the body. It is incurable, but treatable, and most people with lupus will live a normal lifespan.

Women of Afro-Caribbean descent are affected three times more often than other groups. The initial symptoms of lupus are fever, joint pains and fatigue. About 30% of lupus patients have dermatologic symptoms, with 30%-50% getting the characteristic butterfly shaped rash on the face. Another very serious complication is end stage renal disease (ESRD), and kidney transplants are common. There is no single genetic cause for lupus, but many different genes have been identified as contributors to developing lupus.