Signs and Symptoms of Lupus

Lupus can affect any part of the body, resulting in skin rashes and joint problems to an enlarged spleen or inflamed heart muscles. Lupus is a chronic autoimmune disorder, in which the immune system attacks healthy cells or tissues by mistake and causes inflammation throughout the body.

Lupus symptoms also range from mild to severe and look different from person to person. Individual symptoms can affect all parts of the body.

Common Symptoms 

Lupus symptoms look different from person to person, but there are some common symptoms that most people experience with this condition. General symptoms include:

• A red, butterfly-shaped rash
• Disabling fatigue or lack of energy
• Fever
• Joint or muscle pain
• Unintentional weight loss due to stomach issues
• Unintentional weight gain due to water retention

People with lupus may have periods of increased symptoms called flares. They may experience periods when their symptoms are reduced or not as active, or remission. Lupus flares can happen at any time, which makes it difficult for people to manage their condition.  

Musculoskeletal Symptoms

The musculoskeletal system consists of muscles, bones, joints, and the tissues that connect these body parts together. You may have pain in your neck, thighs, shoulders, and upper arms if you have musculoskeletal symptoms.

Joint-related symptoms are typically the first to appear if you have lupus. You might experience pain, swelling, and inflammation in your joints. These symptoms tend to happen in your hands or wrists at first. You can also experience symptoms in any of your joints.

Lupus-related joint symptoms tend to mimic inflammatory arthritis conditions, such as rheumatoid arthritis (RA) or psoriatic arthritis (PsA). People with lupus tend to have more pain than swelling. It's important to note that some people with lupus can also develop erosive arthritis, which causes deformities similar to RA.

Dermatologic Symptoms

Many people with a lupus diagnosis develop dermatologic (skin) symptoms as the condition progresses. A "butterfly rash," or acute cutaneous lupus erythema, occurs on the face across the cheeks and nose. This occasionally painful rash appears after sun exposure and lasts from a few days to weeks.

Other lupus-related skin symptoms include but are not limited to:

• Discoid lesions, or disk-shaped wounds, and scars that develop on areas of your skin that have been exposed to the sun
• Non-scarring alopecia, which causes patchiness and hair loss on parts of the scalp
• Rashes or skin inflammation caused by light sensitivity 
  

Cardiovascular Symptoms

People with lupus can also experience cardiovascular (heart) symptoms. These symptoms can appear in the heart's membrane, muscles, and blood vessels.

You may experience lupus-related heart conditions, such as:

• Myocarditis: Inflammation of the heart muscle called the myocardium
• Pericarditis: Inflammation in the sac-like membrane layer called the pericardium, which covers the heart
• Vasculitis: Inflammation of the blood vessels, which can also affect the arteries
• Thrombosis: A blood clot that develops in the blood vessels, restricting blood flow

Renal Symptoms

About half of the people with lupus experience renal symptoms, or problems with the kidneys. Kidney symptoms can vary from person to person, but it's a significant cause of disability and death in people with lupus.

Healthcare providers may use various lab tests to screen for lupus nephritis, or inflammation in the kidneys. Signs include hematuria (blood in the urine) or proteinuria (protein in the urine). A person can also develop glomerulonephritis, which causes inflammation of the tiny filters in the kidneys called the glomeruli.

Pulmonary Symptoms 

Pulmonary symptoms of lupus affect the lungs and other parts of the respiratory system. The respiratory system is made of organs and tissues that help you breathe.

Lupus-related lung symptoms include:

• Interstitial lung disease: A group of lung disorders that cause scarring of the lungs  
• Pleuritis: Pain in the chest or shoulders due to inflammation of the pleura, or thin layers of tissue that separate your lungs from the chest wall
• Pulmonary hypertension: High blood pressure in the blood vessels that carry blood from the heart to the lungs 

Hematologic Symptoms

Hematologic symptoms involve your blood, bone marrow, lymph nodes, and spleen. Anemia of chronic disease (anemia of inflammation) is the most common type of anemia seen in people with lupus. Anemia is a lack of oxygen-rich red blood cells.

Leukopenia, or a lack of white blood cells, also occurs in about 50% of people with lupus. The condition can cause enlarged lymph nodes and an enlarged spleen, especially during an active lupus flare. 

When To Contact a Healthcare Provider 

Lupus symptoms can mimic those of other health conditions, making diagnosis difficult. It's a good idea to talk to a healthcare provider about getting tested if you have any of the above lupus symptoms. A rheumatologist (who specializes in inflammatory diseases) should diagnose lupus since it's a complex diagnosis to make.

No single test can determine if a person has lupus, but a healthcare provider will likely use a variety of measures to diagnose it. This can include an intake of your medical history, physical exam, and lab tests. The sooner you get tested, the earlier you can begin treatment to reduce symptoms and improve your overall quality of life.

A Quick Review 

Not everyone with lupus has the same symptoms since the condition affects each person uniquely. There are also periods of increased symptoms called flares and periods of reduced symptoms called remission. 

Lupus affects several body parts, so the condition can be difficult to diagnose at first. It's good practice to reach out to a healthcare provider if you notice possible lupus symptoms. They can help you get tested, rule out other conditions, reach a diagnosis, and begin treatment as soon as possible.