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Lupus is a chronic autoimmune condition that can cause inflammation throughout your body. However, it tends to primarily be a localized condition, so it’s not always systemic.
An autoimmune disease is a condition in which your body’s own immune system is responsible for the inflammation and breakdown of its own cells.
Many people with lupus experience a mild version of it, but it can become severe without proper treatment. Currently, there’s no known cure for lupus, so treatment focuses on easing symptoms and reducing inflammation.
The symptoms of lupus can depend on the parts of your body affected. The inflammation seen in lupus can affect various organs and tissues in your body, including your:
Symptoms can vary, depending on the individual. They may be:
- disappear suddenly
- flare up occasionally
Although no two cases of lupus are the same, the most common symptoms and signs include:
- high fever
- body aches
- joint pain
- rashes, including a butterfly rash on the face
- skin lesions
- shortness of breath
- Sjogren’s syndrome, which includes chronic dry eyes and dry mouth
- pericarditis and pleuritis (pleuritis), which both can cause chest pain
- memory loss
The inflammation from lupus can also cause complications involving various organs, such as the:
The symptoms of lupus typically start as you’re entering adulthood. This can be anywhere between your teens and into your 30s.
Some early signs include:
- swollen joints
- dry mouth or dry eyes
- hair loss, especially in patches, which is referred to as alopecia areata
- problems with your lungs, kidneys, thyroid, or GI tract
These are similar to symptoms of other conditions, so experiencing them doesn’t necessarily mean that you have lupus. However, it’s important to make an appointment with your healthcare provider to discuss them.
While too much sun can be harmful to anyone, many people who have lupus also have photosensitivity. Photosensitivity means that you’re particularly sensitive to UV radiation, a type of radiation that’s in sunlight or even certain types of artificial light.
Some people with lupus may find that exposure to sunlight triggers certain symptoms, which can include:
- rash, which are primarily photosensitive rashes when the autoantibody SSA (Ro) is present
- joint pain
- internal swelling
While healthcare providers don’t know exactly what causes lupus, they think it may be a combination of many underlying factors. These include:
- Environment: Healthcare providers have identified potential triggers like smoking, stress, and exposure to toxins like silica dust as potential lupus causes.
- Genetics: More than 50 genes associated with lupus have been identified. Additionally, having a family history of lupus may put a person at slightly higher risk for experiencing the condition.
- Hormones: Some studies suggest that abnormal hormone levels, such as increased estrogen levels, could contribute to lupus.
- Infections: Healthcare providers are still studying the
linkbetween infections like cytomegalovirus and Epstein-Barr, and causes of lupus.
- Medications: Long-term use of certain medications, such as hydralazine (Apresoline), procainamide (Procanbid), and quinidine, have been linked with causing a form of lupus known as drug-induced lupus erythematosus (DIL). Also, patients taking TNF blocker medications for conditions such as rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and ankylosing spondylitis can develop DIL. Though rare, tetracyclines, like minocycline, which can be used to treat acne and rosacea, can cause DIL as well.
It’s also possible to have experienced none of the known potential causes of lupus listed here and yet still have the autoimmune disease.
Certain groups may be at a higher risk of developing lupus. Examples of risk factors for lupus include:
- Sex: Women are more likely to develop lupus than men, but the disease can present as more severe in men.
- Age: While lupus can occur at any age, it’s most often diagnosed in people between the ages of 15 and 44.
- Race or ethnicity: Lupus is more common in certain ethnic groups, such as African American, Hispanic, Asian American, Native American, or Pacific Islander
- Family history: Having a family history of lupus means that you’re at a greater risk of developing the condition.
Remember that having risk factors for lupus doesn’t mean you’ll get lupus. It just means that you’re at increased risk compared to those who don’t have risk factors.
Currently, there’s no cure for lupus. However, there are many different types of treatments that can help you to manage your symptoms.
Treatment for lupus focuses on several factors:
- treating lupus symptoms when you have them
- preventing lupus flares from occurring
- reducing the amount of damage that occurs to your joints and organs
Following your healthcare provider’s recommended treatment regimen is important in helping you to manage your symptoms and to live a normal, fulfilling life.
Healthcare providers and scientists continue their research to better understand lupus and develop new treatments for the condition.
While there’s currently no cure for lupus at this time, medications are available to help you to manage your lupus symptoms and prevent lupus flares. Your healthcare provider will consider your lupus symptoms and their severity when recommending lupus treatments.
It’s important that you see your healthcare provider on a regular basis. This allows them to better monitor your condition and determine if your treatment plan is working to manage your symptoms.
Additionally, your lupus symptoms can change over time. Because of this, your healthcare provider may change your medications or adjust the dosage of current medication.
In addition to medication, your healthcare provider may also recommend lifestyle changes to help manage your lupus symptoms. These can include things such as:
- avoiding excess exposure to ultraviolet (UV) light
- eating a healthy diet
- taking supplements that may help to reduce symptoms, such as vitamin D, calcium, and fish oil
- getting regular exercise
- quitting smoking, if you smoke
The medication that you’re given can depend on your symptoms as well as their severity. Medications can help to address lupus symptoms in several ways, including:
- calming your immune system
- reducing the amount of swelling or inflammation that you experience
- helping to prevent damage to your joints or internal organs
Some examples of lupus medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These can reduce swelling and pain. Examples include over-the-counter medications like ibuprofen (Advil, Motrin) and naproxen (Aleve).
- Antimalarial medications: These drugs were once used to treat the infectious disease malaria. Due to the organism that causes malaria developing a resistance to the drugs, newer meds are now being used to treat the disease. Antimalarial medications can address lupus symptoms like rashes, joint pain, and fatigue. They can also help stop lupus flares. They’re recommended during pregnancy to reduce pregnancy-related complications and the risk of the disease getting worse in the mother.
- Corticosteroids: These drugs help to calm your immune system and can reduce pain and swelling. They come in several forms, including injections, topical creams, and tablets. An example of a corticosteroid is prednisone. Corticosteroids can cause side effects such as infections and osteoporosis. It’s important to minimize dosage and duration of use.
- Immunosuppressive drugs: These medications work to suppress your immune system. Because they’re very strong and can lower your body’s defense against infection, they’re typically only used when lupus is severe or affecting many organs. They’re also used to reduce the amount of and exposure to steroids. This is the reason why they’re also referred to as “steroid-sparing medications.” Examples include methotrexate (Trexall), mycophenolate mofetil (CellCept), mycophenolic acid (Myfortic) and azathioprine (Imuran). These medications are used as
off-labeltreatments for lupus.
- Biologics: Biologics are medications that have a biological origin. Belimumab (Benlysta) is a biologic used to treat lupus. It’s an antibody that can block a protein in your body that’s important for the immune response.
It’s important to monitor how your medications affect your symptoms. If your medication has side effects or doesn’t work to treat your symptoms anymore, let your healthcare provider know.
Healthcare providers haven’t established a specific lupus diet. In general, aim to eat a healthy, well-balanced diet. This can include things like:
- fish high in omega-3 fatty acids, such as salmon, tuna, or mackerel, which consumption of should be monitored due to the need for you to be aware of elevated mercury levels
- foods high in calcium, such as low-fat dairy products
- eating whole-grain carbohydrate sources
- eating a blend of colorful fruits and vegetables
There are also some foods that those with lupus should usually avoid, mostly due to the medications they typically take. Some examples of foods to stay away from include:
- Alcohol: Alcohol can interact negatively with many medications. For example, it can cause gastrointestinal bleeding in people taking NSAIDs. It can also increase the possibility of inflammation.
- Alfalfa: The amino acid known as L-canavanine found in alfalfa sprouts and seeds may increase inflammation and lead to lupus flares.
- Foods high in salt and cholesterol: Not only is cutting back on these beneficial for your overall health, but it also helps to prevent bloating and increases in blood pressure due to corticosteroid use.
Additionally, if you experience photosensitivity due to your lupus, you may lack vitamin D. Taking a vitamin D supplement may help. You can shop for vitamin D supplements online.
Healthcare providers don’t have a single blood test or imaging study to use to diagnose lupus. Instead, they consider a person’s signs and symptoms and rule out other potential conditions that could be causing them.
Research has shown that there are antibodies that are highly specific to lupus, including double-stranded DNA (ds-DNA) and the Smith (Sm) antibody. The Sm antibody is also associated with SLE-related renal disease (nephritis).
Your healthcare provider will first request your medical history and perform a physical examination. They’ll ask about your symptoms, including how long you’ve had them, and if you have a family history of lupus or other autoimmune diseases.
In addition to requesting a detailed medical history and doing a physical examination, your healthcare provider may perform the following tests to diagnose lupus:
- Blood tests: These could include a complete blood count (CBC), a test healthcare providers use to determine the number and type of red blood cells, white blood cells, and platelets in the blood. Other tests they may order include an erythrocyte sedimentation rate, the C-reactive protein (CRP) test, and the anti-nuclear antibody test, which can indicate heightened immune system activity.
- Urine tests: Using urinalysis can determine if there’s an elevated level of blood or protein in your urine. This can indicate that lupus may be affecting your kidneys.
- Imaging tests: Chest X-rays and echocardiograms are two imaging studies that may indicate inflammation or fluid buildup in or around your heart and lungs.
- Tissue biopsy: Your healthcare provider can take a biopsy — or sample of cells — from an area of lupus-like rash to determine if cells typical of a person with lupus are present. If kidney damage is present, a kidney biopsy may be necessary to help determine an appropriate treatment.
Healthcare providers usually categorize four lupus types.
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is the most common type of lupus. When you hear someone say that they have lupus, it’s likely that they’re referring to SLE.
SLE gets its name from the fact that it typically affects several different organ systems of your body, including the:
- nervous system
SLE can range from mild to severe. The condition causes symptoms that may get worse over time and then improve. The times when your symptoms get worse are called flares, while the periods when they improve or go away are called remissions.
This type of lupus is generally limited to your skin. It may cause rashes and permanent lesions with scarring. There are several different types of cutaneous lupus, including:
- Acute cutaneous lupus: This type causes a characteristic “butterfly rash” to occur. This is a red rash that appears on the cheeks and nose.
- Subacute cutaneous lupus: This kind of cutaneous lupus causes a rash that’s red, raised, and scaly to form on the body. It’s often on areas that have been exposed to sunlight and typically doesn’t lead to scarring.
- Chronic cutaneous lupus: This type causes a purple or red rash. It can also cause skin discoloration, scarring, and hair loss. You may also see it called discoid lupus.
While acute cutaneous lupus is often associated with systemic lupus disease, subacute and chronic cutaneous lupus typically only occur on the skin.
This condition is extremely rare and affects infants whose mothers have certain autoimmune antibodies. These autoimmune antibodies are transmitted from mother to fetus across the placenta.
Not all mothers who have these antibodies have symptoms of lupus. In fact, about
Symptoms of this condition may include:
- a skin rash
- low blood cell count
- liver problems after birth
While some babies may have heart defects, most have symptoms that will go away after several months.
However, autoantibodies (SSA/B) can cross the placenta and cause heart conduction problems (heart block).
Patients with these antibodies need to be followed very closely during pregnancy, often by specialists, including a rheumatologist and high-risk obstetrician (fetal-maternal medicine).
Use of certain prescription medications can lead to drug-induced lupus (DIL). DIL may also be referred to as drug-induced lupus erythematosus (DILE).
DIL can develop through the long-term use of certain prescribed medications, typically after just months of taking a drug.
There are many drugs that can cause you to develop DIL. Some examples include:
- antimicrobials, such as terbinafine (an antifungal) and pyrazinamide (a tuberculosis medication)
- anticonvulsant drugs, like phenytoin (Dilantin) and valproate
- arrhythmia drugs, such as quinidine and procainamide
- drugs for high blood pressure, like timolol (Timoptic, Istlol) and hydroxyzine
- biologics called anti-TNF-alpha agents, such as infliximab (Remicade) and etanercept (Enbrel)
While DIL mimics the symptoms of SLE, in most cases the condition doesn’t usually affect major organs. However, it can cause pericarditis and pleurisy. DIL usually goes away within weeks of stopping the medication that caused it to occur.
Lupus isn’t a contagious condition. Contagious means that a condition can be transmitted from one person to another person. Examples of contagious diseases include things like the flu and the common cold.
What exactly causes lupus is quite complex. Instead of “catching” the condition from someone, it’s believed that lupus can be triggered by a combination of factors, including things like:
- your environment
So even though some people with a family history of lupus are more at risk for developing it, they don’t “catch” it from another person. In fact, you could have a family history of lupus and never develop it.
Medical innovations and improvements in diagnostic testing have meant people with lupus are living longer than ever. According to the Lupus Foundation of America, an estimated 80 to 90 percent of people diagnosed with lupus will live a normal lifespan.
People with mild to moderate lupus can do the following to stay healthy and avoid complications:
- Visit their healthcare provider regularly.
- Carefully follow their treatment plan, taking all medications as directed.
- Seek help if they experience new symptoms or side effects from their medications.
- Review risk factors and try to apply actionable steps to reduce them.
- Review the benefits of quitting smoking as it relates to managing lupus symptoms and review resources that provide assistance in quitting smoking if they smoke.
Those who have severe lupus symptoms or who experience a severe flare-up are at greater risk for developing complications than those with mild to moderate lupus. Some complications of lupus can be life-threatening.
A lupus flare happens when your lupus symptoms worsen, making you feel ill. Flares come and go. Sometimes warning signs occur prior to a flare, while other times flares may occur without warning.
There are several different things that can trigger a flare. Some of them include:
- exposure to UV radiation, such as sunlight or fluorescent light
- not getting enough rest
- having an infection or injury
- certain types of medications
- not taking your lupus medications
While lupus treatment can help to prevent flares from occurring, you may still experience one while taking lupus medications. For example, if you’ve been working long hours without getting enough rest, you may have a flare even though you’re taking medication.
Lupus flare symptoms
There are some warning signs that can let you know that a lupus flare is coming. Being able to recognize these signs can help you to seek treatment more promptly, potentially making the flare less severe. Warning signs of a lupus flare include:
- feeling more tired than normal
- pain, especially chest pain that may result from pericarditis or pleurisy
- stomach upset
- feeling dizzy
- severe headache
- swollen lymph nodes
Lupus flares can range in severity from mild to serious. Some may only cause a rash or joint pain, while more serious flares can cause damage to your internal organs. Because of this, it’s always important to seek medical attention.
Lupus is less common in men than it is in women. In fact, according to an
Overall, lupus symptoms are similar between men and women. However, the severity of the condition may differ between sexes.
The evidence on this difference is conflicting. Older studies have suggested that men appear to experience a more severe version than women and may also be more at risk for developing certain lupus complications, including problems with the:
- nervous system
- blood or blood vessels
A 2016 study found no difference in lupus disease characteristics between the sexes, except for hair loss being more obvious in women. However, they did find that men with lupus had higher disease activity at diagnosis.
If you’re a man who’s experiencing symptoms that are consistent with lupus, it’s important that you see your healthcare provider immediately. They can work with you to help determine if lupus or another underlying condition is causing your symptoms.
You have arthritis when your joints become inflamed. This can cause swelling, pain, and a limited range of motion in the affected joint(s). In many cases of arthritis, inflammation occurs due to the wear and tear that occurs in our joints as we age.
Arthritis commonly occurs in people with lupus. However, lupus-related arthritis is due to the increased level of inflammation in the body that’s characteristic of the condition.
The levels of tissue inflammation and damage tend to be less in lupus than in other inflammatory conditions such as rheumatoid arthritis (RA). However, some people may have both lupus and RA.
In the case of lupus and RA, there may be a genetic link between the two conditions.
It’s important to know that women who have lupus can still become pregnant and have healthy children. However, pregnancy in women with lupus is considered high risk. This is because women with lupus may be more at risk for certain types of complications, including:
Some women with lupus are at particularly high risk while pregnant. This includes women with lupus who also have:
- had a lupus flare within the past 6 months
- high blood pressure (hypertension)
- heart failure
- lung disease
- kidney disease or failure
- a previous history of preeclampsia
If you’re planning to get pregnant, make sure that your lupus is properly managed, ideally having been in remission for 6 months. You may also want to seek out an obstetrician who specializes in high-risk pregnancies.
Most women with lupus will go on to have healthy babies. It’s very rare, but sometimes women with lupus can give birth to a baby with neonatal lupus. This type of lupus typically goes away after a few months. However, some infants with neonatal lupus may have serious heart defects.
Lupus is rare in children. In fact, according to a
Similar to lupus in adults, most children who get lupus are female. The common lupus symptoms in children are also similar to those in adults and can include:
- butterfly rash
- weight loss
- joint pain
- loss of appetite
- hair loss
- swollen lymph nodes
Many children who have lupus also have kidney-involved symptoms. It’s estimated that
Since it’s rare and some symptoms may be similar to other childhood conditions, lupus can be difficult to diagnose in children. Like lupus in men, lupus in children is often more active when it’s diagnosed. Because of this, initial treatment may be more aggressive.
Lupus occurs more frequently in women than in men. It’s most common in women who are between the ages of 15 and 44.
Having lupus can also cause some health conditions to occur earlier than they normally would. These include conditions such as:
- Osteoporosis: Some lupus medications can lead to bone loss. Additionally, like lupus, osteoporosis affects more women than men. In fact,
about 80 percentof people with osteoporosis in the United States are women.
- Heart disease: Lupus can contribute to heart disease, as many people with lupus also have heart disease risk factors such as high blood pressure or high cholesterol. Women with lupus may also be
50 times more likelyto have chest pain or a heart attack than women without lupus.
- Kidney disease:
More than halfof people who have lupus also develop kidney problems.
Women of specific ethnic groups may be more likely to experience certain symptoms. African American women with lupus are more at risk for seizures and strokes, while Hispanic and Latina women with lupus are at an increased risk of developing heart problems.
While lupus can affect your health, it doesn’t have to affect your quality of life. By focusing on your medications and wellness, you can live as healthy a life as possible.
In addition to sticking to your treatment plan, some things that you can do at home to help focus on your wellness include:
- Staying active and getting plenty of exercise.
- Eating a healthy, balanced diet.
- Finding ways to manage stress.
- Being sure to get enough rest and not overwork yourself.
Additionally, reading about other people’s lupus journeys may help you to learn more about living with lupus. There are many lupus blogs available that you can dive into.
Sometimes, coping with a diagnosis of lupus may be challenging. It may help to share your experience with others through in-person or online support groups.
There are a variety of complications that lupus-related. They’re caused by the inflammation that’s associated with the condition. Possible complications of lupus can include problems with the:
- Kidneys: The inflammation from lupus can cause kidney damage and can even lead to kidney failure.
- Blood or blood vessels: Blood vessels can become inflamed due to lupus. This is called vasculitis. Additionally, lupus can lead to problems with bleeding or blood clotting.
- Heart: Lupus can also lead to inflammation of your heart and surrounding tissues. It may also put you at a greater risk for heart disease, heart attack, or stroke.
- Lungs: Inflammation of the lungs due to lupus can lead to painful breathing.
- Nervous system: When lupus affects the brain, you can experience bouts of dizziness, headaches, or even seizures.
People with lupus are also more prone to getting infections. This is due not only to the condition itself, but also the fact that many of the medications used to treat lupus weaken or suppress the immune system.
If you have lupus, it’s very important that you stick to the treatment plan that your healthcare provider has developed for you. Doing this can not only help to prevent lupus flares, but it can also help prevent organ damage.
Lupus nephritis is a serious complication that can occur due to lupus. It happens when your immune system attacks the part of your kidneys that works to filter your blood.
It’s important to recognize the symptoms of lupus nephritis so that you can seek prompt treatment. The symptoms can include:
- dark urine
- foamy urine
- bloody urine
- frequent urination, particularly in the evening or at night
- puffiness in the legs, ankles, and feet that gets worse as the day goes on
- weight gain
- high blood pressure
There are several different stages of lupus nephritis – designated Class I through Class VI. Class I is the least severe while Class VI is the most severe.
It’s unclear what exactly causes fatigue in lupus. However, there are factors that may contribute to it, including:
- poor sleep
- low physical activity
- vitamin D deficiency
- pain from lupus arthritis
- side effects of lupus medications
- co-morbid conditions like depression, anemia, or thyroid disease
Some things you can do to help with fatigue include:
- Understand your physical limits. While it’s important to stay active, don’t overdo it. Be sure to rest between activities.
- Try to avoid sleeping during the day. This can interfere with your sleep at night.
- Plan and prioritize tasks. This helps you to better manage when you’re active and when you can get some rest. For example, if you’re out running errands, try to group them together so you don’t have to keep going out.
- Be open about your fatigue. Let your loved ones know what they can do to help.
- Consider joining an in-person or online support group. Doing so can help you learn strategies that other people with lupus use to manage their fatigue.
Coping with lupus can sometimes be difficult. It’s very common to have feelings of frustration or sadness. However, it’s important to distinguish between temporary negative feelings and conditions like depression.
Depression can occur often in people who have lupus. According to a 2018 study, an estimated 25 percent of people with lupus also have depression. Because of this, it’s important to be able to recognize the signs of depression so that you can seek help. These include:
- feelings of sadness, hopelessness, or guilt
- low self-esteem
- crying, which can happen without a specific reason
- difficulty concentrating
- trouble sleeping or sleeping too much
- fluctuations in appetite that cause you to gain or lose weight
- noticing that you’re no longer interested in things that you enjoyed in the past
For most lupus types, the condition isn’t preventable. Drug-induced lupus (DIL) is an exception due to the medications that cause it. However, it’s important that you discuss the risks and benefits as not taking these medications could also result in life-threatening effects.
There are some things you can do to reduce the likelihood of a lupus flare-up. These include:
- Avoiding direct sunlight: Excess sun exposure can cause a lupus-related rash. A person should always wear sunscreen when going outdoors and avoid direct sunlight when the sun’s rays are most overhead, which is usually between 10 a.m. and 4 p.m.
- Practicing stress management techniques: These include meditation, yoga, or massages. They can help you relieve stress whenever possible.
- Practicing infection prevention techniques: This includes frequent handwashing and avoiding being around those with colds and other illnesses that can easily be transmitted from one person to another.
- Getting plenty of rest: Rest is vital to helping your body heal.
Always remember to stick to your treatment plan. Making sure you’re taking your medications not only aids in preventing flares, but it can also help to prevent damage to your internal organs.
If you find that your medications no longer manage your symptoms, see your healthcare provider immediately.