What is Lupus?

Lupus is an autoimmune disease that causes your immune system to attack and damage healthy tissue in many systems of the body. Because of lupus, various areas of the body, including the joints, kidneys, brain, skin, heart, lungs, and blood cells, become inflamed. Symptoms of lupus range from mild to serious depending on the person and the severity of the lupus. 

Although lupus shares many symptoms with other autoimmune conditions, there are distinctive symptoms that can help detect lupus and get an accurate diagnosis. The most recognizable symptom of lupus is a facial rash that resembles a butterfly that forms on the cheeks. While there is no cure for lupus, there are treatments and management techniques that help address the symptoms and reduce inflammation. 

Lupus is a common disease, affecting roughly 1.5 million Americans with over 16,000 new cases getting diagnosed each year. These figures likely do not capture the full scope of the disease since many people do not seek or confirm a diagnosis.

What are the different types of lupus?

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There are four main types of lupus a person can develop. Each of the four have some commonality, but each type is unique in its impact on the body. 

  • Systemic lupus erythematosus (SLE): SLE is the most common form of lupus that causes inflammation that impacts many organ systems in the body. Symptoms of SLE range from mild to severe and involve fatigue, pain, rash, and fever. Roughly 50% of SLE cases will have inflammation that affects major organs, like the heart, kidneys, lungs, or brain. 
  • Cutaneous lupus: This form of lupus impacts just the skin. Symptoms of cutaneous lupus include hair loss, ulcers, sun sensitivity, rashes, and swelling of the blood vessels. The primary sign of this form of lupus is the butterfly-shaped facial rash that appears across the nose and cheeks. 
  • Drug-induced lupus: High doses of certain medications can trigger lupus and mimic the symptoms of SLE. These symptoms typically subside, however, with the discontinued use of the medication. Medicines used to treat chronic health problems like seizures, rheumatoid arthritis, or high blood pressure are the most common causes of drug-induced lupus. 

Neonatal lupus: This form of lupus develops in fetuses when a mother’s antibodies mistakenly affect the fetus. Babies born with neonatal lupus tend to have a skin rash, liver problems, or low blood cell counts. These symptoms typically go away with no lasting effects after several months.

What causes lupus?

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There is no known cause of lupus, but doctors do know what happens internally that causes the symptoms of lupus. Lupus causes your immune system to attack healthy cells in your body and mistake healthy tissue for a danger posed to your body. While health professionals have yet to determine what biologically causes lupus, they have been able to identify possible triggers of the conditions. These triggers indicate that lupus could be a result of a person’s genetics and environment. 

  • Genetic disposition: A person’s genetic makeup and family history of lupus may mean that an external trigger could cause lupus to manifest. 
  • Medications: Some medications can trigger lupus if taken in too high a dose. This type of lupus typically resolves when the person stops taking the medication that triggered the condition. 
  • Sunlight exposure: Sun exposure to the skin may trigger an immune response that causes lupus for people at a higher risk of lupus. 
  • Infections: Infections could start a relapse of lupus that might have been in remission or trigger the condition to manifest for the first time. 
  • Hormones: Hormone imbalances could cause lupus in people who have trouble regulating their hormones or who have an excess of specific hormones. 
  • Environment: Your physical surroundings, including your exposure to pollutants or sunlight, can trigger lupus. 
  • Health history: Stress, smoking, and other autoimmune conditions could contribute to the cause of lupus. 

What are symptoms of lupus?

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Each case of lupus is unique, and each person’s symptoms of lupus will have differences. In addition, lupus shares symptoms with other conditions, so the following symptoms could indicate lupus or another disorder. Documenting your symptoms is helpful in identifying the condition. Symptoms or signs of lupus can occur over a longer period or appear very suddenly. In many cases, the following symptoms occur during flares that last for a period of time then wane into periods of remission. 

The severity and types of symptoms you have can depend on where lupus is active in the body and what body systems are involved. More common symptoms include:

  • Fever
  • Joint pain and swelling
  • Fatigue 
  • Chest pain or shortness of breath
  • Skin lesions after sun exposure 
  • Butterfly-shaped rash across the face 
  • Headaches or memory loss
  • Dry eyes 
  • Hair loss
  • Mouth or nose sores 
  • Swelling in the face, arms, or legs
  • Finger and toes turning white or blue when cold 

Someone with lupus may only experience some of these symptoms, and symptoms may come and go over time. The variety of symptoms can make lupus hard to diagnose and ultimately leaves many cases of lupus undetected or undiagnosed.

Are there any risk factors or groups for lupus?

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There are risk factors that may increase a person’s risk of lupus. People can have a higher likelihood of lupus if they fall into the following risk factor groups. 

  • Sex: Women and people assigned female at birth aged 15 to 44 are much more likely to have lupus than males or people assigned male at birth due to hormonal factors. 
  • Race: Lupus is less common for white people than it is for African American, Hispanics, Asian Americans, Native Americans, Alaska Natives, or Pacific Islanders. 
  • Age: Lupus is not common for people younger than 15. The condition most often occurs in people between the ages of 15 and 45 but can also occur in people outside this age range. 
  • Family History: People with a biological parent who has lupus are more likely to develop lupus. 

How is lupus diagnosed?

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Because lupus shares signs and symptoms with other conditions, confirming a lupus diagnosis can be challenging. There is not a designated examination that can test for lupus. Instead, medical professionals use a combination of tests to diagnose. 

Your doctor will use a review of your medical history and symptoms, laboratory tests, imaging tests, and a potential biopsy to assess your condition. Blood and urine tests look for anemia or elevated protein levels, which signal organ malfunction characteristic of lupus. Your doctor may order an x-ray or echocardiogram if lupus may be affecting your heart or lungs to look for fluid buildup and valve function. Finally, a kidney tissue biopsy can help identify the best treatment option if the kidneys are impacted.

How is lupus treated?

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Since lupus symptoms can change over time, the best treatment plan for lupus also changes over time to address current symptoms. Your doctor will help you determine which symptoms need immediate attention and factor in your other health conditions to develop the best plan for you. 

The most common treatment for lupus are medications that are prescribed to manage symptoms and pain. These medications include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids
  • Immunosuppressants
  • Antimalarial drugs

Your doctor may need to address your dosage over time as you encounter flares of periods of remissions to respond to your current symptoms. It is important to attend regular checkups and communicate any new or worsening symptoms to your doctor as soon as you notice them. 

Should you see a doctor for lupus?

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You should see a doctor when you first notice symptoms, no matter how subtle. Early intervention is best for an effective treatment plan. In addition, after you start treatment for lupus, you should see your doctor if your condition does not improve or you notice concerning side effects. 

You should seek emergency medical care or go to the hospital if you have trouble breathing, are experiencing signs of a heart attack, or are in severe pain.

What is the outlook for people living with lupus?

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There is no cure for lupus, so it is a chronic condition you will have to live with and manage for life. It is important to stay in contact with your primary care physician as well as your specialists for your lupus to ensure your medication is up to date and your symptoms are under control. 

With effective symptom management, your daily life should not experience major disruptions. However, you may need to adjust your lifestyle to work through flares and adjust to limitations brought on by your symptoms.

What are the complications of lupus?

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Having lupus increases your risk of developing other medical conditions. Mainly, lupus can make you more likely to have the following:

  • Cancer 
  • Pregnancy complications
  • Osteoporosis 
  • Heart disease
  • Kidney disease
  • Anemia
  • Depression
  • Infection
  • Photosensitivity 
  • Dry eye 

Not all of these complications are life-threatening, but some do require more immediate medical attention to protect your health and receive appropriate treatment. To stay ahead of possible complications, you should schedule regular checkup appointments with your healthcare team to assess your symptoms and treatment.