Lupus is a chronic autoimmune disease. It can cause many different symptoms, including fever, fatigue, rashes, body aches, and confusion. While there’s no cure, your care team may recommend medications, and dietary and lifestyle changes to manage these symptoms.
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.
Healthcare professionals 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 they’re referring to SLE.
SLE gets its name from the fact that it typically affects several different organ systems of your body.
- nervous system
SLE can range from mild to severe. The condition causes symptoms that may get worse over time and then improve. According to the Lupus Foundation of America, the times when your symptoms get worse are called flares. The periods when they improve or go away are known as remissions.
This type of lupus is generally limited to your skin. It may cause rashes and permanent lesions with scarring. A
- 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 lupus in other parts of the body, subacute and chronic cutaneous lupus typically only occur on the skin.
This condition is extremely rare and affects infants whose birthing parents have certain autoimmune antibodies. These autoimmune antibodies are transmitted from parent to fetus across the placenta.
Not all parents who have these antibodies have symptoms of lupus. In fact, research shows that about
Symptoms of this condition may include:
- a skin rash
- low blood cell count
- liver problems after birth
While some babies may have developmental issues in the heart, most have symptoms that will go away after several months.
If you have these antibodies, you’ll need to be followed very closely during pregnancy. Your care team will often include specialists, such as a rheumatologist and high risk obstetrician. An obstetrician is a doctor who specializes in fetal-maternal medicine.
The use of certain prescription medications can lead to drug-induced lupus (DIL). DIL may also be referred to as drug-induced lupus erythematosus (DILE).
Many drugs 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 hydralazine
- 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.
Currently, there’s no cure for lupus. However, many different types of treatments can help you manage your symptoms.
According to a
- 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 a healthcare professional’s recommended treatment regimen is important in helping you to manage your symptoms and to live a fulfilling life.
Doctors and scientists continue their research to better understand lupus and develop new treatments for the condition.
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 permanent
- disappear suddenly
- flare up occasionally
No two cases of lupus are the same. But the
- high fever
- body aches
- joint pain
- rashes, including a butterfly rash on the face
- skin lesions
- shortness of breath
- Sjögren’s syndrome, which includes chronic dry eyes and dry mouth
- pericarditis and pleuritis, which both can cause chest pain
- memory loss
The inflammation from lupus can also cause complications involving various organs, such as the:
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 ultraviolet (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, according to the Lupus Foundation of America. These can include:
- rashes, which are primarily photosensitive rashes when a certain antibody called SSA (Ro) is present
- joint pain
- internal swelling
If you have lupus and are going to be outside, it’s important to wear sun-protective clothing and apply sunscreen.
The symptoms of lupus typically start as you’re entering adulthood. This can be anywhere from your teens to 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, or gastrointestinal 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 a healthcare professional to discuss them.
While there’s currently no cure for lupus at this time, medications are available to help you manage your lupus symptoms and prevent lupus flares. A doctor will consider your lupus symptoms and their severity when recommending lupus treatments.
It’s important that you see your doctor on a regular basis. This allows them to better monitor your condition and determine if your treatment plan is working to manage your symptoms.
Your lupus symptoms can also change over time. Because of this, your doctor may change your medications or adjust the dosage of current medication.
The National Health Service (NHS) says that in addition to medication, your doctor may also recommend lifestyle changes to help manage your lupus symptoms. These can include things such as:
- avoiding excess exposure to 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
According to a
- 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. The organism that causes malaria developed a resistance to the drugs, so doctors now use newer medications 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 parent.
- 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-label treatmentsfor 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 doctor know.
Healthcare professionals haven’t established a specific diet for people with lupus. But a
In general, aim to eat a well balanced diet. This can include things like:
- fish high in omega-3 fatty acids, such as salmon, tuna, or mackerel
- foods high in calcium, such as low fat dairy products
- whole grain carbohydrate sources
- a blend of colorful fruits and vegetables
If you’re eating fish high in omega-3 fatty acids, you may need to monitor your consumption. These fish can have elevated mercury levels.
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 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 is found in alfalfa sprouts and seeds. This amino acid may increase inflammation and lead to lupus flares.
- Foods high in salt and cholesterol. Cutting back on salt and cholesterol isn’t just beneficial for your overall health. 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.
Skin rashes are a common symptom of lupus that many people experience.
Rash typically occurs after sun exposure. According to a
Skin rashes may also appear as patches or ring-shaped lesions on the:
- upper back
These rashes may be raised, smooth, or scaly and can be painful or itchy in some cases. The rashes usually also appear red or purple and may be more noticeable in people with darker skin tones, according to a
While experts don’t know exactly what causes lupus, they think it may be a combination of many underlying factors. These include:
- Environment. A
2019 reviewidentified potential triggers like smoking, stress, and exposure to toxins like silica dust as potential lupus causes.
- Genetics. According to the Lupus Foundation of America, 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. A
2019 reviewsuggests that atypical hormone levels, such as increased estrogen levels, could contribute to lupus.
- Infections. According to a
2021 review, experts are still studying the link between lupus and infections like cytomegalovirus and Epstein-Barr.
- Medications. Long-term use of certain medications, such as hydralazine (Apresoline), procainamide (Procanbid), and quinidine, has been linked with DIL. Also, people taking TNF blocker medications for conditions such as rheumatoid arthritis (RA), inflammatory bowel disease, 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. According to the Lupus Foundation of America, examples of risk factors for lupus include:
- Gender. 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.
- Family history. Having a family history of lupus means that you’re at a greater risk of developing the condition.
- Ethnicity. In the United States, Lupus is more common in People of Color, Black People, Hispanic People, Latino People, Asian People, Native Americans, Native Hawaiians, and Pacific Islanders, than in Caucasian people. Lupus can develop earlier in age and be more severe in the above groups of people.
Researchfrom 2014 shows that 1 in 537 Black females in America are affected by Lupus. Researchersare not completely certain if this is due to genetic or socioeconomic factors (or both.) The LUMINA studysheds some light on factors that may play a role. However, more research is needed to determine why lupus predominantly affects these groups.
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.
Doctors don’t use a single blood test or imaging study 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 some antibodies 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 doctor 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.
According to a
- Blood tests. These could include a complete blood count. Doctors use this test 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, C-reactive protein test, and antinuclear 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 doctor can take a biopsy — or sample of cells — from an area of lupus-like rash. This may help 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.
A variety of complications are lupus-related. They’re caused by the inflammation that’s associated with the condition. Possible complications of lupus can include problems with the:
- Kidneys. According to a
2020 study, the inflammation from lupus can cause kidney damage and even lead to kidney failure.
- Blood or blood vessels. A
2020 reviewindicates that 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, according to a
2020 study. It may also put you at a greater risk of heart disease, heart attack, or stroke.
- Lungs. A
2020 reviewfound that 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, according to a
People with lupus are also more prone to getting infections. This is due to not only 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 doctor has developed for you. Doing this can help prevent lupus flares and also organ damage.
Lupus nephritis is a serious complication that can occur due to lupus, according to a
It’s important to recognize the symptoms of lupus nephritis so that you can get 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 people with lupus. However, some factors may contribute to it, including:
- poor sleep
- low physical activity
- vitamin D deficiency
- pain from lupus arthritis
- side effects of lupus medications
- comorbid 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.
Lupus and depression
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 recognize the signs of depression so that you can get 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
- changes 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
You have arthritis when your joints become inflamed. This can cause swelling, pain, and a limited range of motion in the affected joints.
Joint inflammation tends to be from autoimmune arthritis, like RA. However, many cases of arthritis occur due to the wear and tear, or osteoarthritis, that happens in our joints as we age.
The levels of tissue inflammation and damage within the joints tend to be less in lupus than in other inflammatory conditions such as 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.
A lupus flare happens when your lupus symptoms worsen, making you feel ill. Flares come and go. Sometimes warning signs occur before a flare, while other times flares may occur without warning.
Several different things can trigger a flare. According to a
- 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
Some warning signs can let you know that a lupus flare is coming. Being able to recognize these signs can help you to seek treatment more promptly. This can potentially make the flare less severe.
According to the
- feeling more tired than usual
- pain, especially chest pain that may result from pericarditis or pleurisy
- upset stomach
- feeling dizzy
- severe headache
- Raynaud’s phenomenon
- 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.
Medical innovations and improvements in diagnostic testing have meant people with lupus are living longer than ever. In fact, survival rates are estimated to be around
People with mild to moderate lupus can do the following to stay healthy and avoid complications:
- Visit your doctor regularly.
- Carefully follow your treatment plan, taking all medications as directed.
- Seek help if you experience new symptoms or side effects from your medications.
- Review risk factors and try to take steps to reduce them.
- Make a smoking cessation plan with your doctor, if you smoke.
Those who have severe lupus symptoms or who experience a severe flare are at greater risk of developing complications than those with mild to moderate lupus. Some complications of lupus can be life threatening.
Is lupus contagious?
Lupus isn’t a contagious condition.
What exactly causes lupus is quite complex. According to the NHS, instead of “catching” the condition from someone, it’s believed that lupus can be triggered by a combination of factors. These include things like:
- your environment
So even though some people with a family history of lupus are more at risk of developing it, they don’t “catch” it from another person. In fact, you could have a family history of lupus and never develop it.
How is lupus in men different?
Lupus is less common in men than it is in women. In fact, a 2019 study estimated that only about
Overall, lupus symptoms are similar between men and women. However, the severity of the condition may differ between genders. In fact, men may have more severe disease than women, including kidney disease and pleuritis.
A 2016 study found no difference in lupus disease characteristics between the genders, except for hair loss being more obvious in women. However, they did find that men with lupus had higher disease activity at diagnosis.
How is lupus in women different?
Lupus occurs more frequently in women than in men. The CDC says that it’s most common in women who are between the ages of
Having lupus can also cause some health conditions to occur earlier than they typically would.
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.
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 of 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
- heart failure
- lung disease
- kidney disease or failure
- a previous history of preeclampsia
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 developmental issues in the heart.
How is lupus in children different?
Lupus is rare in children.
Similar to adults, most children who get lupus are female. The common lupus symptoms in children are also similar to those in adults. According to the Lupus Foundation of America, they can include:
- butterfly rash
- weight loss
- joint pain
- loss of appetite
- hair loss
- swollen lymph nodes
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.