10 Early Signs of Lupus

Medically reviewed by Nancy Carteron, MD, FACR on April 5, 2017Written by Ann Pietrangelo and Kristeen Cherney

What is lupus?

Lupus is an autoimmune disease that causes swelling (inflammation) and a wide variety of symptoms. Lupus affects everyone differently. 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 into the 30s. People with lupus generally experience flare-ups of symptoms followed by periods of remission. That’s why early symptoms are easy to dismiss.

Because early symptoms are similar to those of other conditions, having them doesn’t necessarily mean you have lupus. Early symptoms can include:

  • fatigue
  • fever
  • hair loss
  • rash
  • pulmonary problems
  • kidney problems
  • swollen joints
  • gastrointestinal problems
  • thyroid problems
  • dry mouth and eyes

Learn more: Visualize the effects of lupus on the body »

1. Fatigue

About 90 percent of people with lupus experience some level of fatigue. 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 difficult, but if you can remain active and stick to a daily routine, you may be able to keep your energy levels up.

Speak to your doctor if you’re living with debilitating fatigue. Some causes of fatigue can be treated.

2. Unexplained fever

One of the early symptoms of lupus is a low-grade fever for no apparent reason. Because it may hover somewhere between 98.5˚F (36.9˚C) and 101˚F (38.3˚C), you might not think to see a doctor. People with lupus may experience this type of fever off and on.

A low-grade fever could be a symptom of inflammation, infection, or imminent flare-up. If you have recurrent, low-grade fevers, make an appointment to see your doctor.

3. Hair loss

Thinning hair is often one of the first symptoms of lupus. Hair loss is the result of inflammation of the skin and scalp. Some people with lupus lose hair by the clump. 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. But if you develop lesions on your scalp, hair loss in those areas may be permanent.

4. Skin rash or lesions

One of the most visible symptoms of lupus is a butterfly-shaped rash that appears over the bridge of the nose and on both cheeks. About 50 percent of people with lupus have this rash. It 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 people with lupus are sensitive to the sun, or even to artificial lighting. Some experience discoloration in the fingers and toes.

butterfly rash

5. Pulmonary issues

Inflammation of the pulmonary system is another possible symptom of lupus. The lungs become inflamed, and the swelling can extend to lung blood vessels. Even the diaphragm may be affected. These conditions can all lead to chest pain when you try to breathe in. This condition is often referred to as pleuritic chest pain.

Over time, breathing issues from lupus can shrink lung size. Ongoing chest pain and shortness of breath characterize this condition. It’s sometimes called vanishing (or shrinking lung syndrome). The diaphragmatic muscles are so weak they appear to move up in CT scan images, according to the Lupus Foundation of America.

6. Kidney inflammation

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:

Early symptoms may go unnoticed. After diagnosis, monitoring of kidney function is recommended. Untreated lupus nephritis can lead to end-stage renal disease (ESRD).

7. Painful, swollen joints

Inflammation can cause pain, stiffness, and visible swelling in your joints, particularly in the morning. It may be mild at first and gradually become more obvious. Like other symptoms of lupus, joint problems can come and go.

If over-the-counter (OTC) pain medications don’t help, see your doctor. 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.

8. Gastrointestinal problems

Some people with lupus experience occasional heartburn, acid reflux, or other gastrointestinal problems. Mild symptoms can be treated with OTC antacids. If you have frequent bouts of acid reflux or heartburn, try cutting down on the size of your meals, and avoid beverages containing caffeine. Also, don’t lie down right after a meal. If symptoms continue, see your doctor to rule out other conditions.

9. Thyroid problems

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 also result in weight gain or weight loss. Other symptoms include dry skin and hair, and moodiness.

When a thyroid is underactive, the condition is known as hypothyroidism. Hyperthyroidism is caused by an overactive thyroid. Treatments to get your metabolism back on track are available.

10. Dry mouth, dry eyes

If you have lupus, you may experience dry mouth. Your eyes may feel gritty and dry, too. That’s because some people with lupus develop Sjogren’s disease, another autoimmune disorder. Sjogren’s causes the glands responsible for tears and saliva to malfunction, and lymphocytes can accumulate in the glands. In some cases, women with lupus and Sjogren’s may also experience dryness of the vagina and skin.

Other symptoms

The list of potential symptoms of lupus is lengthy. Other symptoms include oral ulcers, enlarged lymph nodes, muscle pain, chest pain, osteoporosis, and depression. Rare symptoms include anemia, dizziness, and seizures.

Fortunately, not everyone gets every symptom. While new symptoms can appear, others often disappear.

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