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Lupus Treatment in Singapore

A/Prof Leong Keng Hong - Senior Consultant Rheumatologist
A/Prof Leong Keng Hong Senior Consultant Rheumatologist MBBS (S'pore), MRCP (Int Med) (UK), MMed (Int Med) (S'pore), FAMS (Rheumatology) (S'pore), FRCP (Int Med) (UK), MD (S'pore)

Lupus can be difficult to recognise because it affects everyone differently. Some individuals experience ongoing fatigue and joint discomfort, while others may develop skin changes or complications involving internal organs. These issues may also fluctuate over time, with periods of worsening followed by improvement, making diagnosis more challenging.

If you have been experiencing persistent or unexplained health concerns, seeking medical advice can help provide clarity and guide the next steps. With an accurate diagnosis, appropriate treatment and ongoing follow-up, many people with lupus can manage their condition effectively and continue leading active, fulfilling lives.

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What Is Lupus?

Systemic lupus erythematosus (SLE), commonly known as lupus, is a chronic autoimmune disease in which the body's immune system mistakenly attacks healthy tissues and organs. This abnormal immune response causes inflammation that may affect various parts of the body.

Under normal circumstances, the immune system produces antibodies to protect against infections caused by bacteria and viruses. In people with lupus, the immune system produces autoantibodies that target the body's own cells and tissues, resulting in ongoing inflammation and tissue damage.

Lupus can affect multiple organs and systems, including the skin, joints, kidneys, lungs, heart, liver, blood cells, gastrointestinal tract, and the brain and nervous system. Although lupus can affect both men and women, approximately 90% of people diagnosed with SLE are women, particularly during their childbearing years.

What Are the Different Types of Lupus?

Lupus can occur in several forms. While systemic lupus erythematosus is the most common type, other forms primarily affect the skin or occur under specific circumstances.

Systemic Lupus Erythematosus (SLE)

SLE is the most common and potentially serious form of lupus. It can affect multiple organs and systems throughout the body, with symptoms ranging from mild to severe.

Drug-Induced Lupus

Certain medications can trigger lupus-like symptoms. Commonly implicated drugs include some anti-hypertensive, anti-arrhythmic and anti-seizure medications. Symptoms usually improve once the medication is discontinued under medical supervision.

Neonatal Lupus

Neonatal lupus is a rare condition affecting babies born to mothers with specific autoantibodies. Symptoms may include skin rashes, liver abnormalities or blood count changes. Most manifestations resolve over time, although some infants may develop congenital heart block.

Cutaneous Lupus

Cutaneous lupus primarily affects the skin. Individuals may develop rashes or lesions that worsen with sun exposure.

Common skin manifestations include:

  • Acute cutaneous lupus, which may cause the characteristic butterfly-shaped malar rash across the cheeks and bridge of the nose
  • Chronic cutaneous lupus (discoid lupus), which causes thick, scaly lesions that may leave permanent scarring

What Are Common Signs and Symptoms of Lupus?

Lupus is often referred to as the "great imitator" because its symptoms can resemble those of many other medical conditions. Symptoms may also fluctuate over time. Many individuals experience periods of increased disease activity known as flares, followed by periods where symptoms improve or become less noticeable. Because lupus can affect different organs, symptoms vary considerably between individuals. Common signs and symptoms include:

  • Fatigue
  • Joint pain and swelling
  • Headaches
  • Skin rashes, including the characteristic malar or "butterfly" rash across the cheeks and nose
  • Mouth or nose ulcers
  • Swollen lymph nodes
  • Fever
  • Muscle aches
  • Hair loss
  • Sensitivity to sunlight (photosensitivity)
  • Chest pain or shortness of breath
  • Raynaud's phenomenon, where fingers or toes turn pale or blue in response to cold or stress

In some cases, lupus may also affect major organs such as the kidneys, brain, lungs, heart, or blood cells, leading to more serious complications.

Concerned about symptoms that could be linked to lupus?

Early evaluation can help provide clarity and guide appropriate treatment.

Schedule a consultation with A/Prof Leong Keng Hong today.

What Are Possible Causes of Lupus?

The exact cause of lupus remains unknown. Current research suggests that the condition develops through a combination of genetic predisposition, immune system abnormalities, hormonal influences and environmental triggers.

  • Hormones

    The higher prevalence of lupus among women, particularly during their reproductive years, suggests that female hormones such as oestrogen may influence disease development and activity.
  • Environment

    Exposure to certain environmental elements can trigger the onset of lupus, including exposure to UV rays from tanning, overexposure to sunlight, viral infections, emotional stress, smoking and exhaustion.
  • Accelerated Cell Death (Apoptosis) and Autoantibody Production

    Research suggests that abnormalities in the clearance of dead or damaged cells may expose the immune system to cellular material that should normally remain hidden. This can contribute to the production of autoantibodies and sustained immune activation seen in lupus.
  • Genetics

    Lupus itself is not directly inherited. However, individuals with a family history of lupus or other autoimmune diseases may have a higher risk of developing the condition.
  • Medications

    It's possible for the autoimmune disorder to be triggered by antibiotics, blood pressure and anti-seizure medications. For those with drug-induced lupus, treatment simply comes in the form of not taking the medicine.

    • What Are Possible Risk Factors of Lupus?

    Certain factors that increase the risk of developing the condition include:

    Gender
    GenderWomen are significantly more likely than men to develop lupus, particularly between puberty and menopause.
    Age
    AgeLupus most commonly develops between the ages of 15 and 45, although it can occur at any age. Approximately 15% of cases begin before adulthood.
    Family History
    Family HistoryIndividuals with first- or second-degree relatives who have lupus or another autoimmune disease may have an increased risk.
    Drug-Related Factors
    Drug-Related FactorsCertain medications may trigger temporary lupus-like symptoms in susceptible individuals.
    Ethnicity
    EthnicityLupus occurs in all ethnic groups but tends to be more common and sometimes more severe among people of Asian, African, Hispanic and Indigenous ancestry.
    Immune System Dysfunction
    Immune System DysfunctionUnderlying abnormalities in immune regulation can increase susceptibility to autoimmune diseases, including lupus.

    Early recognition of lupus can help reduce the risk of long-term complications.

    Arrange an consultation with A/Prof Leong Keng Hong if you are experiencing ongoing symptoms or have concerns about your risk factors.

    How Is Lupus Diagnosed?

    Diagnosing lupus can be challenging because its symptoms often overlap with those of other conditions. There is no single test that can definitively diagnose lupus.

    Your rheumatologist will typically assess your medical history, symptoms, physical examination findings and investigation results before reaching a diagnosis.

    Laboratory tests may include:

  • Full Blood Count (FBC)

    Checks for anaemia and abnormalities involving white blood cells or platelets.

  • Erythrocyte Sedimentation Rate (ESR)

    Measures inflammation levels within the body.

  • Kidney and Liver Function Tests

    Evaluate how well these organs are functioning and whether lupus-related inflammation is present.

  • Anti-ds DNA Antibody Test

    This antibody is more specific for lupus and may help assess disease activity, particularly when kidney involvement is suspected.

  • Urine Tests (Urinalysis)

    Assesses for protein or blood in the urine, which may indicate kidney involvement.

  • Biopsy

    A kidney or skin biopsy may be performed when organ involvement is suspected to assess the extent of inflammation or damage.

  • Antinuclear Antibody (ANA) Test

    ANA is positive in the majority of patients with lupus and is commonly used as a screening test.

    • Imaging tests may include:

  • X-rays or Ultrasounds

    Chest X-rays and echocardiograms may be used to evaluate the lungs and heart.

  • CT or MRI Scans

    These imaging studies help assess organ involvement and identify complications affecting areas such as the brain, lungs or blood vessels.

    • The findings from these investigations help determine the extent of disease involvement and guide treatment planning.

    What Lupus Treatments Are Available?

    There is currently no known cure for lupus, but researchers are continually carrying out clinical trials for new treatments that might help better detect and treat this disease. Lupus treatments today are focused on managing symptoms and preventing the condition from worsening. The primary treatment for lupus includes:

    Medications

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

    These medications can help relieve pain, stiffness and inflammation.
  • Antimalarial Drugs

    Hydroxychloroquine is a disease-modifying anti-rheumatic drug (DMARD) commonly prescribed for lupus. It can help control symptoms, reduce flare frequency and improve long-term outcomes.
  • Corticosteroids

    These can reduce inflammation and control illnesses that cause damage to the brain and kidneys.
  • Immunosuppressants

    These medications reduce immune system activity and may be recommended for moderate to severe disease or organ involvement.
  • Biologics and Monoclonal Antibodies

    Targeted therapies such as biologic medications may be considered for patients whose symptoms remain active despite conventional treatment. These therapies act on specific immune pathways involved in lupus.

    • Lifestyle Modifications

    Patients are often advised to:

    • Protect themselves from excessive sun exposure
    • Avoid smoking
    • Maintain regular physical activity
    • Prioritise adequate sleep
    • Manage stress levels

    Regular Monitoring

    Ongoing follow-up allows disease activity, medication response and potential complications to be monitored closely.

    Preventive Measures

    Vaccinations, cardiovascular risk management and osteoporosis prevention may form part of a comprehensive lupus management plan.

    Because lupus affects each person differently, treatment should be individualised. A rheumatologist can help develop a management strategy that addresses your specific symptoms and health goals.

    Managing Lupus with A/Prof Leong Keng Hong

    Lupus can affect multiple aspects of your health and quality of life, but early diagnosis and appropriate treatment can help control symptoms, reduce flares and lower the risk of complications. At Leong Keng Hong Arthritis & Medical Clinic in Singapore, patients receive comprehensive care for lupus and other autoimmune conditions. A/Prof Leong Keng Hong provides personalised treatment plans tailored to each individual's symptoms, disease activity and healthcare needs. Schedule a consultation with A/Prof Leong Keng Hong to receive an accurate diagnosis and personalised management plan.

    Other Services We Provide

    There are more than 100 different types of rheumatic disorders. Our team works together to diagnose and treat the full spectrum of these disorders, including autoimmune diseases, such as lupus, rheumatoid arthritis and psoriatic arthritis, as well as other forms of arthritis, such as osteoarthritis and gout. Treatments for the various conditions may include lifestyle changes, medication and surgery. A/Prof Leong will tailor each treatment plan to effectively manage the condition in each patient.

    Click on each service to find out more

  • Arthritis
  • Rheumatoid Arthritis (RA)
  • Systemic Lupus Erythematosus (SLE)
  • Ankylosing Spondylitis (AS)
  • Psoriatic Arthritis
  • Sjogren's Syndrome
  • Joint Pain
  • Scleroderma, Systemic Sclerosis
  • Gout

    • Frequently Asked Questions (FAQs) About Lupus

    What are the first signs of lupus?

    Early symptoms of lupus can be non-specific and vary between individuals. Common initial signs include persistent fatigue, joint pain, muscle aches, low-grade fever and skin rashes. Some people may also notice hair loss, mouth ulcers or increased sensitivity to sunlight. Because these symptoms overlap with many other conditions, medical evaluation is often needed for diagnosis.

    Can lupus be cured?

    There is currently no cure for lupus. However, modern treatments can effectively control inflammation, reduce disease activity and prevent complications. Many patients are able to achieve prolonged periods of remission and maintain a good quality of life with appropriate treatment and regular follow-up.

    Does lupus affect fertility and pregnancy?

    Most women with lupus can become pregnant and have successful pregnancies. However, pregnancy should ideally be planned when the disease is well controlled. Active lupus may increase the risk of complications for both mother and baby, making close monitoring by both a rheumatologist and an obstetrician important.

    Is lupus life-threatening?

    Most people with lupus today live significantly longer and healthier lives than in the past due to advances in treatment. However, severe organ involvement affecting the kidneys, heart, lungs or brain can lead to serious complications if not managed appropriately. Early diagnosis and regular treatment are important for improving outcomes.

    Is lupus painful?

    Pain is a common symptom of lupus. Individuals may experience joint pain, muscle aches, chest discomfort or headaches depending on the areas affected. The severity of pain varies from person to person and may fluctuate during disease flares.

    Can I lead a normal life with lupus?

    Many individuals with lupus are able to work, exercise and participate in daily activities. Successful long-term management often involves a combination of medication, lifestyle adjustments and regular medical follow-up. Early intervention and adherence to treatment can help minimise flares and maintain quality of life.

    Meet Our Lupus Specialist in Singapore

    A/Prof Leong Keng Hong - Senior Consultant Rheumatologist

    A/Prof Leong Keng Hong

    Senior Consultant Rheumatologist

    MBBS (Singapore) · MMed (Singapore) · MD · MRCP (UK) · FAMS (Singapore) · FRCP (Edinburgh)

    A/Prof Leong Keng Hong is a senior consultant rheumatologist with more than 25 years of experience in rheumatology, having been in private practice at Gleneagles Medical Centre since 1997. His clinical interests include gout and other rheumatic conditions affecting the joints and connective tissues. He is also an Adjunct Associate Professor at the Yong Loo Lin School of Medicine, National University of Singapore, and previously served as the inaugural Chairman of the Chapter of Rheumatologists at the Academy of Medicine, Singapore.

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