Lupus is an autoimmune disease that causes swelling (inflammation) and a wide variety of symptoms. Lupus affects each individual uniquely. Some people have only a few mild symptoms and others have many, more severe symptoms.
Symptoms usually start in early adulthood, anywhere from the teen years to the 30s. As with some other autoimmune diseases, people with lupus generally experience flare-ups of symptoms followed by periods of remission. That’s why early signs are easy to dismiss.
Because early symptoms are similar to those of so many other conditions, having them doesn’t necessarily mean you have lupus.
A whopping 90 percent of people with lupus experience some level of fatigue, according to the Johns Hopkins Lupus Center. An afternoon nap does the trick for some people, but sleeping too much during the day can lead to insomnia at night. It may be hard to do, but if you can remain active and stick to a daily routine, you may be able to keep your energy levels up.
If you are living with debilitating fatigue, speak to your doctor. Some causes of fatigue can be successfully treated.
One of the early signs of lupus is a low-grade fever for no apparent reason. Because it may hover somewhere between 98.5 and 101 degrees Fahrenheit, you won’t necessarily think to see a doctor. People with lupus may experience this type of fever in an on-again, off-again fashion. Low-grade fever could be a sign of inflammation, infection, or imminent flare-up. If you have recurrent, low-grade fevers, make an appointment to see your doctor.
Thinning hair is often one of the first signs of lupus. Hair loss is the result of inflammation of the skin and scalp. Some people with lupus lose hair by the clump, but more often, hair thins out slowly. Some people also have thinning of the beard, eyebrows, eyelashes, and other body hair. Lupus can cause hair to feel brittle, break easily, and look a bit ragged, earning it the name “lupus hair.”
Lupus treatment usually results in renewed hair growth. However, if you develop lesions on your scalp, hair loss in those areas may be permanent.
One of the most visible signs of lupus is the butterfly-shaped rash that appears over the bridge of the nose and both cheeks. About 50 percent of people with lupus have this rash, according to the Johns Hopkins Lupus Center. The rash can occur suddenly or appear after exposure to sunlight. Sometimes the rash appears just before a flare-up.
Lupus can also cause non-itchy lesions in other areas of the body. Rarely, lupus can cause hives. Many lupus patients are sensitive to the sun, or even to artificial lighting. Some experience discoloration in the fingers and toes.
Inflammation of the pulmonary system is another possible marker of lupus. Not only can the lungs themselves become inflamed, but the swelling can also extend to lung blood vessels. Even the diaphragm may be affected. These can all lead to chest pain when you try to breathe in, a condition often referred to as pleuritic chest pain.
Over time, breathing issues from lupus can literally shrink lung size. Also called vanishing (or shrinking) lung syndrome, this condition is characterized by ongoing chest pain and shortness of breath. The diaphragmatic muscles are so weak that they appear to move up in CAT scan imagery, according to the Lupus Foundation of America.
People with lupus can develop a kidney inflammation called nephritis. Inflammation makes it harder for the kidneys to filter toxins and waste from the blood. According to the Lupus Foundation of America, nephritis usually begins within five years of the start of lupus.
Symptoms include swelling in the lower legs and feet, and high blood pressure. You may notice blood in your urine, or have to go more frequently at night. Also, you may have a pain in your side and your urine may be a bit darker than usual. Early signs may go unnoticed. Once diagnosed, monitoring of kidney function is recommended. Untreated lupus nephritis can lead to end-stage renal disease (ESRD).
Inflammation can cause pain, stiffness, and visible swelling in your joints, particularly in the morning. It may be mild at first, gradually becoming more obvious. Like other symptoms of lupus, joint problems can come and go.
If over-the-counter pain medications don’t help, see your healthcare professional. There may be better treatment options, but your doctor must determine if your joint problems are caused by lupus or another condition, such as arthritis.
Some people with lupus experience occasional heartburn, acid reflux, or other gastrointestinal problems. Mild symptoms can be successfully treated with over-the-counter antacids. If you have frequent bouts of acid reflux or heartburn, try cutting down on the size of your meals. Avoid beverages containing caffeine. Don’t lie down right after a meal. If symptoms continue, see your doctor so other conditions can be ruled out.
It’s not uncommon for people with lupus to develop autoimmune thyroid disease. The thyroid helps control your body’s metabolism. A poorly functioning thyroid can affect vital organs like your brain, heart, kidneys, and liver. It can result in weight gain or weight loss. Other symptoms include dry skin and hair, as well as moodiness.
If you have lupus, you may have dry mouth. Your eyes may feel gritty and dry, too. That’s because some lupus patients develop Sjogren’s syndrome, another autoimmune disorder. Sjogren’s syndrome causes malfunctioning of the glands responsible for tears and saliva. In some cases, women with lupus may also experience dryness of the vagina.
Fortunately, not everyone gets every symptom. While new symptoms can appear on the scene, old ones often disappear.