Signs & Symptoms of Lupus

Lupus is a complex autoimmune disorder that can manifest in myriad ways, making it a challenge to diagnose and understand. For many, the journey with lupus begins with subtle symptoms that may be easily dismissed or mistaken for other conditions. Gaining a comprehensive understanding of lupus and its diverse symptoms is crucial for early recognition, effective management, and improved quality of life.

What Is Lupus?

Lupus is an autoimmune condition, meaning the body’s immune system mistakenly attacks its own tissues and organs. This can lead to inflammation and damage to various parts of the body, including the joints, skin, kidneys, heart, lungs, brain, blood cells, and liver. The symptoms of lupus are incredibly diverse and can range from mild to severe. They can come and go, and may change over time. Diagnosing lupus early is crucial, as early recognition and treatment can significantly affect the course of the disease, helping to manage symptoms and reduce the risk of long-term damage. (Source)

Common Types of Lupus

There are several types of lupus, and understanding them can provide a clearer picture of this condition.

Systemic Lupus Erythematosus (SLE)

This is the most common form of lupus, affecting multiple parts of the body. Symptoms can range from mild to severe, and the disease can cause periods of illness and remission. (Source)

Cutaneous Lupus Erythematosus

This type primarily affects the skin, leading to rashes and lesions, often in areas exposed to the sun. (Source)

Drug-Induced Lupus Erythematosus

This is when symptoms similar to lupus are developed after exposure to certain types of medications. (Source)

Neonatal Lupus

This rare condition occurs when an infant acquires autoantibodies from a mother with lupus. It can cause skin rashes and sometimes more serious issues, but these symptoms gradually improve over several months. (Source)

Understanding Lupus: Prevalence and Risk Factors

Higher Prevalence in Women

Lupus predominantly affects women. In fact, women are 9 times more likely to develop lupus than men. The reasons for this disparity are not entirely clear, but hormonal differences are believed to play a significant role. Estrogen, a hormone more prevalent in women during their early reproductive years, has been shown to stimulate the immune system, which could contribute to the development of autoimmune conditions like lupus in women who are already predisposed to the disease. Genetic variations in the X chromosomes (females have two of these) as well as cytokines (small proteins that play a key role in the immune system) produced by the fetal placenta during pregnancy may also increase lupus risk. (Source)

Ethnic Disparities

Lupus is more common and tends to be more severe in people of African, Asian, and Hispanic descent. These ethnic groups are not only at a higher risk of developing lupus but also tend to experience more severe symptoms and complications, which may be due at least in part to socioeconomic factors. (Source, Source)

Genetic Predisposition

While the exact cause of lupus is still unknown, genetics plays a crucial role. If you have a family member with lupus or another autoimmune condition, your risk of developing lupus is higher. However, it’s important to note that having a genetic predisposition does not guarantee you will develop lupus; lifestyle, environmental, and hormonal factors also play significant roles. (Source)

General Symptoms of Lupus: Navigating the Subtle Signs

Lupus can sometimes present with subtle symptoms that might be easily overlooked, but these seemingly minor symptoms can have a profound effect on daily life and overall well-being. Let’s delve into some of the general symptoms of lupus and understand their significance.

Fatigue

One of the most frequently reported symptoms among lupus patients is fatigue, which is experienced by up to 90% of individuals with the condition. This isn’t just the usual tiredness that a good night’s sleep can fix — it’s a profound exhaustion that can make it hard to perform normal daily activities. (Source)

Fever

Unexplained low-grade fevers are another common symptom of lupus. These fevers are usually mild but can be a sign that the immune system is active, indicating a lupus flare. (Source)

Weight Changes

Both weight loss and weight gain can be associated with lupus. These fluctuations can result from the disease itself, medications, changes in appetite, or changes in activity levels due to other lupus symptoms. (Source, Source)

Understanding Musculoskeletal Symptoms

Lupus can affect the musculoskeletal system, which includes bones, muscles, joints, and connective tissue. Let’s explore what types of musculoskeletal symptoms you may experience with lupus.

Joint Pain and Stiffness: A Common Challenge

One of the most common musculoskeletal symptoms in lupus is joint pain and stiffness, particularly in the morning. This can affect any joint but is most commonly experienced in the hands, wrists, and knees. The pain and stiffness can vary in intensity and duration, and it may be accompanied by swelling in the affected joints. (Source)

Muscle Aches and Pains: More Than Just Soreness

Muscle aches, or myalgias, are also common among those with lupus. These aches can range from mild discomfort to severe pain, and they may be constant or intermittent. In some cases, lupus can lead to inflammation of the muscles, a condition known as myositis, which can result in weakness and loss of muscle mass. (Source)

Effect on Mobility and Quality of Life

Lupus can have a profound impact on an individual’s mobility and quality of life. Joint pain and stiffness can limit movement, making daily activities challenging and leading to a decrease in independence. Muscle aches and weakness can further contribute to this loss of function. (Source, Source)

Dermatological Symptoms of Lupus

All forms of lupus can affect the skin.

Skin Rashes: Visible Manifestations of Lupus

Skin rashes can take various forms, but the butterfly-shaped rash across the cheeks and nose, also known as a malar rash, is one of the most distinctive signs of lupus. (Source)

Photosensitivity: Navigating Sun Exposure

Many with lupus experience photosensitivity, meaning their skin is more susceptible to damage from UV rays. This can lead to rashes, itching, and other skin issues after sun exposure. It is crucial for those with lupus to take protective measures, such as wearing sunscreen with a high SPF, donning protective clothing, and avoiding peak sun hours. (Source)

Other Skin-Related Symptoms

Lupus can also cause other skin conditions, such as discoid lupus lesions, which are thick, red, scaly patches that can result in scarring. There’s also cutaneous vasculitis, where inflamed blood vessels lead to small red or purple dots on the skin. (Source)

Understanding Gastrointestinal Symptoms in Lupus

Lupus can affect various parts of the digestive system and lead to a range of symptoms, such as:

• mouth: Sores and ulcers can be a common occurrence, causing discomfort and pain.
• esophagus: Reduced esophageal motility — the sequence of contraction and relaxation of the muscles of the esophagus — is disrupted in up to 72% of those with lupus. This can cause difficulty swallowing. Acid reflux may also occur in SLE patients and contribute to inflammation in the esophagus. Some symptoms of acid reflux include heartburn, vomiting, and belching. 
• stomach and intestines: Inflammation can lead to abdominal pain, bloating, nausea, and changes in bowel habits.
• pancreas and liver: Lupus can affect these organs, potentially leading to liver inflammation or pancreatitis, though the latter happens in a very small percentage of people.

(Source, Source) 

Blood-Related Symptoms in Lupus

Anemia

Anemia is present in more than 50% of people with lupus and is characterized by a reduced number of red blood cells or a lack of hemoglobin, the protein in red blood cells that carries oxygen. This leads to fatigue, weakness, pale skin, and shortness of breath. Lupus can cause anemia through various mechanisms including inflammation, which can interfere with the production and lifespan of red blood cells. (Source)

Clotting Issues

Lupus can also affect the blood’s ability to clot properly, leading to an increased risk of bleeding or, conversely, the formation of blood clots in veins and arteries. This is often due to the presence of antiphospholipid antibodies, which can make the blood more prone to clotting. It’s also important to note that the risk of blood clotting isn’t necessarily related to the severity of disease activity. This means antiphospholipid antibodies can still cause clotting issues even after you’ve gotten your SLE symptoms under control. (Source, Source)

Leukopenia and Lymphopenia 

Lupus can also affect white blood cell count, both in terms of leukocytes in general (leukopenia) and the specific subgroup of white blood cells known as lymphocytes (lymphopenia). Lymphopenia has been linked to lupus nephritis (kidney inflammation), higher steroid doses, and consumption of the medication cyclophosphamide. (Source)

Given the important role white blood cells play in the body’s defense against bacteria, viruses, and other microbes, a decrease in their numbers can significantly compromise the immune system. Consequently, patients with lupus often experience frequent infections or find that minor infections quickly escalate into major ones. (Source)

Interestingly, the severity of leukopenia and lymphopenia often fluctuates in concert with the overall disease activity of lupus. Therefore, careful monitoring of any infections, abnormal skin conditions, swollen lymph nodes, or symptoms of lupus nephritis (such as blood in the urine) can help catch issues with the white blood cell count. (Source, Source)

Organ-Specific Manifestations and Complications

Cardiovascular and Pulmonary Symptoms

Lupus can cause inflammation in different parts of the heart and lungs, causing a variety of cardiovascular and pulmonary symptoms. 

• cardiovascular symptoms: These can include chest pain, palpitations, and fatigue. In some cases, lupus can lead to silent heart diseases such as inflammation of the heart muscle, known as myocarditis. (Source)
• pulmonary symptoms: Breathlessness, coughing, and chest discomfort are common. Conditions such as pleuritis, where the lining of the lungs becomes inflamed, can cause sharp chest pain. Additionally, interstitial lung disease can lead to progressive scarring of lung tissue, affecting the ability to breathe. (Source)

The Effects of Lupus on the Eyes

Lupus can also affect the eyes and the area around the eyes. The eyes are delicate organs, and lupus-related inflammation can be significant if not addressed promptly and appropriately.

Common Eye Symptoms in Lupus

• dry eyes: Many with lupus experience dry eyes, a condition that can cause discomfort, redness, and a gritty sensation. 
• eye pain and sensitivity: Inflammation in the eyes due to lupus can result in eye pain, which may be accompanied by redness and sensitivity to light.
• change in vision: The blood vessels in the retina may be affected by lupus, potentially leading to changes in vision. This might manifest as blurriness, dark spots, or difficulty focusing.
• vision loss: In severe cases, lupus-related eye complications can lead to vision loss. Early detection and management of eye symptoms are crucial to preventing permanent damage to vision.
• changes to the eyelid: Lupus can cause inflammation in the eyelids, leading to redness, swelling, and scaly lesions. In some cases, eyelids can become scarred and misshapen.

(Source, Source)

Kidney Involvement

Prevalence of Lupus Nephritis

Lupus nephritis is a common complication of lupus in which the kidneys become inflamed, impairing their ability to filter waste from the blood and control the balance of fluids and electrolytes in the body. Some studies have indicated that nephritis develops in up to 40% of patients with SLE, often manifesting early in the disease course. (Source, Source)

Symptoms of Lupus Nephritis

Patients with lupus nephritis may experience a range of symptoms, including:

• swelling in legs, ankles, or feet
• high blood pressure
• foamy urine
• blood in urine
• frequent urination during the night

(Source)

Neurological and Psychological Effects

Neurological Effects

Lupus can directly influence the brain and nervous system, leading to cognitive disturbances. Some individuals with lupus may experience:

• memory problems: difficulty in recalling past events or information
• confusion: a sense of disorientation or difficulty in understanding situations
• trouble concentrating: struggling to focus on tasks, or being easily distracted

(Source, Source)

Psychological Impact

The emotional toll of living with a chronic illness like lupus can be immense. Common psychological symptoms include:

• anxiety: persistent feelings of unease, such as worry or fear. This can range from mild to severe.
• depression: persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in most activities

(Source)

Dispelling Myths about Lupus

Lupus is a multifaceted autoimmune disease, and there are many misconceptions surrounding it. Dispelling these myths helps to reduce stigma and misinformation, creating a more supportive environment for those affected by lupus. If you or someone you know has lupus, it’s important to seek information from reliable sources and work closely with health care providers to manage the condition effectively.

Myth 1: Lupus Is Contagious 

One common misconception is that lupus is contagious. This is not true. Lupus is an autoimmune disease, which means the body's immune system attacks its own tissues and organs. It is not caused directly by an infectious virus or bacteria and cannot be spread from person to person. (Source, Source) 

Myth 2: Only Women Get Lupus 

While it is true that lupus is more common in women, men can also develop the disease and tend to have more severe symptoms. (Source) 

Myth 3: Lupus Is a Form of Cancer 

Lupus is not a form of cancer, although it may be treated with anti-inflammatory chemotherapy drugs. Cancer is a condition where cells in the body grow out of control, while lupus is an autoimmune disease. However, people with lupus may be at an increased risk for certain types of cancer. (Source, Source) 

Myth 4: Lupus Always Causes Severe Disability 

Lupus affects everyone differently, and the severity of symptoms can vary widely. Some people with lupus live with mild symptoms, while others may experience more severe symptoms. With proper treatment and management, many people with lupus lead full, active lives. (Source) 

Myth 5: If You Have Lupus, You Can’t Get Pregnant 

Women with lupus can have successful pregnancies. However, lupus can increase the risk of complications during pregnancy, so it’s important for women with lupus to work closely with their health care team before and during pregnancy. (Source) 

A Holistic Approach to Lupus Management

Lupus is a chronic autoimmune disease that can affect various parts of the body, and managing it often requires a comprehensive and holistic approach. Integrative care, which combines conventional medical treatments with complementary therapies, plays a crucial role in managing lupus and enhancing the quality of life for those living with this condition.

Understanding Integrative Care

Integrative care involves a patient-centered approach. It combines standard medical treatments with evidence-based complementary therapies to address not just the disease itself, but also overall well-being.

Benefits of Integrative Care for Lupus

1. symptom management: Integrative care can help manage common lupus symptoms such as pain, fatigue, and stress. Techniques such as massage therapy and mindfulness meditation have been shown to be effective in reducing pain and improving mood. (Source)
2. emotional support: Living with a chronic disease like lupus can take a toll on mental health. Integrative care provides support through counseling, support groups, and mind–body practices such as yoga and tai chi, which can help reduce anxiety and improve mood. (Source, Source)
3. improved quality of life: By addressing both the physical and emotional aspects of lupus, integrative care can lead to an improved quality of life. Patients often report feeling more in control of their health and better able to cope with their condition.
4. personalized care: Integrative care is tailored to the individual needs of the patient. This personalized approach ensures that the care plan addresses the unique symptoms, lifestyle, and preferences of each person.
5. enhanced self-management: Integrative care empowers patients to take an active role in their health. Education on lifestyle modifications, such as diet and exercise, as well as stress management techniques, enables patients to better manage their condition.

Integrating Conventional and Complementary Therapies

It’s important to note that integrative care is not a replacement for conventional medical treatments. Medications and other medical interventions remain a critical component of lupus management. Integrative care works alongside these treatments to enhance their effectiveness and manage any side effects.

Working closely with your health care team, you can develop a care plan that complements your medical treatments. It’s crucial to communicate openly about all the therapies being used to ensure they are safe and coordinated.

How WellTheory Can Help

Navigating through life with lupus can be challenging, but you don’t have to do it alone. WellTheory is here to provide a supportive community and personalized care to help you manage your condition effectively. Our approach is compassionate, evidence-based, and tailored to meet your unique needs and goals.

A Care Team That Understands

Our care team at WellTheory is composed of professionals who specialize in autoimmune diseases, ensuring that you receive expert guidance and support. We understand the complexities of lupus and are committed to helping you navigate your journey with empathy and expertise. 

Care Tailored to Your Goals and Needs

At WellTheory, we recognize that every individual has unique needs and goals. Our care plans are personalized to align with your lifestyle, preferences, and health objectives. We work collaboratively with you to create a care plan that is both achievable and sustainable, ensuring that you feel supported every step of the way.

Daily Guidance and Collaboration

Managing lupus requires ongoing attention and adjustment. WellTheory provides daily guidance and support to help you stay on track and make informed decisions about your care. Our collaborative approach ensures that you are an active participant in your autoimmune journey, empowering you to take control of your health.

Evidence-Based and Data-Driven Care Plans

Our care plans are grounded in the latest scientific research and clinical evidence, ensuring that you receive the most up-to-date and effective interventions. We utilize data-driven approaches to monitor your progress and adjust your care plan as needed, ensuring that your treatment is always tailored to your current needs.

The Bottom Line

The signs and symptoms of lupus can vary from person to person. Understanding these symptoms, and recognizing their effects on your daily life, is a crucial step towards effective management and care.