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Lupus: Symptoms, causes, treatment and prevention

Lupus: Symptoms, causes, treatment and prevention
Submitted and Medically Reviewed By: Dr. Mavra Farrukh

Overview

Lupus is an autoimmune condition affecting millions around the globe. The Lupus Foundation of America states that around 1.5 million Americans and 5 million people worldwide are affected by lupus. Since lupus involves multiple body systems, including the skin, kidneys, joints, lungs, heart, and peripheral blood cells, a thorough understanding of the condition is necessary to manage it. 

What is lupus?

Systemic lupus erythematosus (SLE), referred to as lupus, is a chronic autoimmune disease that can cause pain and inflammation throughout your body. In cases of an autoimmune disease, your body’s immune system attacks healthy tissue.

Joint pain, rashes, and skin sensitivities are the common symptoms that people with lupus experience. Internal organs such as the kidneys, lungs brain and heart may also be affected if you have lupus. In some individuals, lupus symptoms might be mild. While in some, severe symptoms can occur, which can have an impact on a person’s daily life. Symptoms can happen now, and then that is referred to as flare-ups.

Is lupus more common in women?

Lupus is much more common amongst women. According to statistics, 9 out of 10 cases occur in women. Women are mostly diagnosed between the ages of 15 and 44. Although the exact cause of lupus hasn’t been identified, the hormone estrogen may contribute to this condition. 

How is lupus in men different?

Lupus is less common in men as compared to women. A study concluded that only 1 out of 10 people with lupus are male. 

Generally, lupus symptoms are almost the same in both men and women. Although, the severity of the condition can differ between genders. Usually, men have more severe disease than women, leading to kidney disease and pleuritis.

What causes lupus?

The exact cause of lupus has not been identified. There is ongoing research to find out the reason why lupus occurs. However, some factors that could result in lupus include:

  • Hormonal changes: Women are more likely to have lupus compared to men. The hormone estrogen has been identified as a possible cause. That is why lupus is more common in women during their reproductive years when estrogen levels are higher.
  • Family history: A genetic link in developing the disease has been identified. Suppose you have family members with lupus and your risk of the disease increases.
  • Environmental factors: Environment factors can also increase your risk of getting lupus. Some factors that have shown to increase the risk include exposure to sunlight, certain medications, viruses or infections or stress. A history of smoking is one other factor.

Risk factors for developing lupus

Certain factors put you at a higher risk of developing lupus. Some risk factors include: 

  • Gender. Women are likely to be diagnosed with lupus, but the disease can be more severe in men.
  • Age. The age group affected by the disease ages 15 to 44 but lupus can occur at any age.
  • Family history. If someone in a family history of lupus that can increase your risk of having the condition.
  • Ethnicity. It has been observed that in the United States, lupus is more common in People of Color, Black People, Latino People, Asian People, Native Americans, Hispanic People, and Pacific Islanders than in Caucasian people. 
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What are the symptoms of lupus in women?

There are a range of symptoms you might experience if you have lupus. Not everyone with lupus will experience the same symptoms. Although lupus symptoms in women and lupus symptoms in men are generally the same, the severity of the disease can vary. It has been noted that symptoms are more severe in men. Additionally, many of these symptoms may overlap with those that can occur with other medical conditions. This is why lupus disease may be challenging to diagnose.

Early lupus symptoms may develop gradually. Over time, new symptoms or signs of lupus in women can appear. The severity of symptoms can also change over time. Sometimes symptoms may flare up or be absent for a while (in remission), 

The symptoms of lupus typically depend on the parts of the body involved. The inflammation present in lupus causes various organs and tissues in your body to be affected, including: 

  • skin
  • heart
  • kidneys
  • lungs
  • joints
  • brain
  • blood

Symptoms can vary from individual to individual. Symptoms may 

  • persist 
  • disappear suddenly
  • flare up occasionally

There can be a variation in symptoms in different cases of lupus. The most common symptoms and signs include:

  • high fever
  • fatigue
  • rashes 
  • butterfly rash on the face is considered characteristic 
  • body aches
  • joint pain
  • skin lesions
  • shortness of breath
  • pericarditis and pleuritis
  • headaches
  • confusion
  • memory loss
  • Sjögren’s syndrome 

The inflammation that stems from lupus can also lead to complications affecting various organs, such as the:

  • kidneys
  • blood
  • lungs

What is the lupus rash?

A skin rash is one typical symptom of lupus. Lupus rash often results from prolonged sun exposure, usually lasting days to weeks. The rash can appear on the face, wrists or hands. 

Butterfly rash on face

The lupus rash on the face extends across the bridge of your nose and onto both sides of your cheeks. This characteristic rash is called “butterfly rash” because of its shape. 

Mild lupus can present as skin rashes which are itchy or may cause discomfort. These rashes can sometimes fade, but some may cause sores on the skin. 

Skin rashes can appear on other areas of the body, including:

  • chest
  • arms
  • neck
  • shoulders
  • scalp
  • face
  • legs
  • upper back

These rashes can be smooth, scaly or raised in appearance. They can be painful or itchy in some cases. The rashes usually appear red or purple and may be more prominent in people with darker skin tones. 

What are the different types of lupus?

There are many different types of lupus. Systemic lupus erythematosus is the most prevalent. Other types of lupus include:

Cutaneous lupus erythematosus: 

This type of lupus primarily affects the skin. People with mild cutaneous lupus erythematosus usually experience skin sensitivity to the sun and may develop a lupus sun rash. These symptoms can be associated with hair loss.

Discoid lupus erythematosus (DLE) is a form of cutaneous lupus erythematosus. Early-stage discoid lupus rash is usually mild. People with discoid lupus develop round sores on their face or scalp. Discoid lupus is also termed chronic cutaneous lupus.   

Drug-induced lupus: 

Certain medications trigger these cases of lupus. The condition is usually temporary, and people with drug-induced lupus usually have many symptoms of systemic lupus erythematosus. This type of lupus disappears after discontinuing the medication causing it.

Neonatal lupus: 

This rare type of lupus affects infants at birth. Children born with this condition have antibodies passed to them from their mothers, who either had lupus during pregnancy or possibly developed the condition later in life. However, every baby born to a mother with lupus will not necessarily have the disease. 

How is lupus diagnosed?

The process of diagnosis can be challenging. This is mainly because symptoms can overlap with other conditions, such as arthritis or diabetes. In addition, symptoms of lupus sometimes take time to develop, increasing the time it takes to reach a diagnosis.

Your doctor will initially take your family history to see if someone has lupus in your family. After that, the physician may discuss the symptoms that you have been experiencing. After some lab tests are ordered, these tests are done to look for things like low blood cell counts and other abnormalities.

How do they test for lupus?

A single blood test or imaging study cannot provide a definite diagnosis for lupus. Usually, a person’s presenting signs and symptoms are considered to rule out other potential conditions that could be causing them. 

After a detailed medical history and carrying out a physical examination, the doctor may order the following tests to diagnose lupus:

  • Blood tests. A complete blood count is done to check the number of red blood cells, white blood cells, and platelets in the blood. Other tests ordered include a C-reactive protein test, erythrocyte sedimentation rate, and an antinuclear antibody test. The antinuclear antibody (ANA) test looks for antibodies/proteins in your body. The presence of such antibodies can be a sign of an autoimmune disease. Individuals who have systemic lupus erythematosus usually test positive for ANAs.

Research has concluded that some antibodies, such as double-stranded DNA (ds-DNA) and the Smith (Sm) antibody, are highly specific to lupus. The Sm antibody is closely linked with SLE-related renal disease. 

  • Urine tests. Urinalysis can determine if there’s an elevated blood level or protein in your urine. This indicates that lupus may be affecting your kidneys.
  • Imaging tests. Chest X-rays and echocardiograms can help see if there is any inflammation or buildup of fluid in or around your lungs or heart.
  • Tissue biopsy. A biopsy from an area of the lupus-like rash might be taken to confirm the diagnosis. A kidney biopsy may be required to devise the best possible treatment plan in case of kidney damage.
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Treatment for lupus

Lupus treatment depends on several factors, including:

  • Your current symptoms and complications.
  • The severity of your symptoms.
  • Your age.
  • Your current medications.
  • Your medical history.
  • Your overall health.

Lupus is a chronic condition that has to be managed regularly. The goal of treatment is to reach a state of remission and limit the amount of damage to the organs. Unfortunately, lupus is unpredictable and how the condition can impact your life. Therefore, it is very crucial to follow up with a doctor regularly to modify the treatment plan according to the symptoms.

Some people with mild symptoms of lupus may require monitoring and close follow-ups or limited treatment. Others may require an aggressive treatment plan based on the severity of the disease, particularly because they might be at risk of more severe complications such as those affecting the heart, lung or kidneys. Your doctor will provide the best treatment options based on a patient’s symptoms, complications and medical history.

Medication used to treat lupus:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). This type of drug reduces swelling and pain. Examples include ibuprofen (Advil, Motrin) and naproxen (Aleve).
  • Antimalarial medications. Antimalarial medications can be used to manage lupus symptoms such as rashes, joint pain, and fatigue. They can also help halt or reduce the incidence of lupus flares. These are generally prescribed during pregnancy to reduce complications and the risk of the disease worsening in the parent. One such medication is hydroxychloroquine, and it is also used to treat mouth sores and fatigue associated with lupus.
  • Corticosteroids. These drugs suppress the immune system helping reduce inflammation, pain and swelling. Several forms are available, including injections, tablets and topical creams. One commonly prescribed corticosteroid is prednisone. Corticosteroids may lead to side effects such as infections and osteoporosis. Minimising dosage and duration of use is essential to prevent side effects.
  • Immunosuppressive drugs. These medications suppress the immune system. These drugs, in turn, lower your body’s defence against infection, which is why they are used only in case of severe disease. Although, they’re also used to reduce the dosage and duration of steroids. This is why they are also called steroid-sparing medications. Examples include methotrexate, azathioprine, mycophenolate mofetil or mycophenolic acid. 
  • Biologics. Belimumab is an example of a biologic used to treat lupus. This medication comes under monoclonal antibody that reduces the activity of white blood cells that make autoantibodies, the main cause of tissue damage. Belimumab is used to treat cases that do not respond to other treatment types or diseases that have not affected the kidneys. Rituximab is another monoclonal antibody that reduces the activity of white blood cells damaging the body’s tissue/organs. It’s sometimes used to treat lupus, which is refractory to other forms of treatment.

Lupus diet

There is a well-established link between the benefit of a particular diet for people with lupus, but some studies suggest that dietary changes may be beneficial.

A diet containing the following may help reduce symptoms or help prevent a flare-up:

  • fish such as salmon, tuna, or mackerel
  • foods high in calcium, such as low-fat dairy products
  • whole grains
  • fruits and vegetables

Taking Vitamin supplements may help combat the photosensitivity caused by lupus. 

Although, monitoring your consumption of such fish is required as these fish can have elevated mercury levels.

Some particular foods that those with lupus should avoid, primarily due to their medications, include:

  • Alcohol. Since alcohol interacts with several medications, it is best to avoid it. It can lead to gastrointestinal bleeding in people taking NSAIDs or directly increase inflammation.
  • Alfalfa. L-canavanine is an amino acid found in alfalfa sprouts and seeds. This contributes to inflammation and lupus flares and must be avoided.
  • Foods that are high in salt and cholesterol. Reducing salt and cholesterol helps reduce bloating and the risk of increased blood pressure due to corticosteroid use.

Lupus flare

A lupus flare occurs when lupus symptoms worsen, and the person’s condition worsens accordingly. Flares can come and go. Initially, an individual may experience some warning signs before a flare-up, but this is not always the case; flares may occur without warning.

Different factors can trigger a flare, including:

  • exposure to UV radiation
  • an infection or injury
  • stress
  • not getting sufficient rest
  • certain medications
  • not taking your lupus medications

Sticking to the treatment plan can help prevent flares, but you may still experience symptoms due to the abovementioned factors while taking lupus medications.  

Lupus flare symptoms

Some warning signs can let you predict a lupus flare-up. If one can pick up these signs on time, treatment can be sought, and the severity of a flare-up can be reduced. 

Some of these warning signs that may pre-hint a lupus flare include:

  • fatigue
  • rash
  • chest pain
  • fever
  • upset stomach
  • dizziness
  • severe headache
  • swollen lymph nodes
  • Raynaud’s phenomenon

Lupus flare-ups can be mild to severe. Mild cases cause a rash or joint pain. Severe flares can cause damage to internal organs. Consequently, it’s always important to consult with your doctor.

Lupus complications

A wide array of complications can occur due to lupus. The underlying inflammation that’s associated with the condition leads to these complications. Such complications include: 

  • Kidneys. The inflammation due to lupus can cause kidney damage and eventually cause kidney failure.
  • Blood or blood vessels Inflammation of blood vessels, also called vasculitis can occur due to lupus. Moreover, lupus may also result in blood clotting.
  • Heart. Lupus can cause inflammation of the heart or surrounding tissues, increasing your risk of heart disease, heart attack, or stroke.
  • Lungs. Inflammation of the lungs can occur as well due to lupus that presents as painful breathing.
  • Nervous system. When lupus affects the brain, you can experience bouts of dizziness, headaches, or even seizures, according to a 

Individuals who have lupus are generally more prone to getting infections. This is because the medications used to treat lupus weaken the immune system.

Is lupus contagious?

Lupus is not a contagious disease. You cannot catch the condition from someone. Instead, it is caused by a combination of factors, including genetics, your environment and hormones.

Why does lupus cause hair loss?

Damage to your skin and hair loss are common side effects experienced by people with lupus. Hair loss can result from scarring on the skin and scalp from rashes. Hair loss and thinning can also be a side effect of some medications that treat lupus, such as steroids. To minimise such side effects, it is best to inform your doctor so that supporting treatment can be provided. 

Why does lupus cause weight gain or weight loss?

Many people with lupus may experience weight loss. This can be caused by the disease itself or the medications prescribed to treat it. Some individuals may gain weight due to prolonged inactivity due to joint pain. It’s crucial to maintain a healthy diet when you have lupus. 

Is lupus cancer?

Systemic lupus erythematosus, or lupus, is an autoimmune disease. It is a chronic condition, and it is not classified as cancer. Although, it is linked to an increased risk of certain types of cancer. Studies indicate that lupus patients have an elevated risk of lymphoma and other cancers, including cancer of the cervix.

Lupus vs psoriasis

Lupus is a chronic connective tissue disease that affects any part of the body.

Skin, joints, kidneys, blood, heart, lungs, and brain are most commonly affected. 

Common symptoms experienced by the patient include fever, fatigue, hair loss, facial rash, chest discomfort and swollen joints. 

On the other hand, psoriasis is an autoimmune condition characterised by patches of abnormal skin. Red patches of skin, dry, cracked skin, itching, burning, swollen and stiff joints. The patches appear on the scalp, torso, knees or elbows. Other areas affected include the palms, face, soles, genitals or nails.

Lupus rash vs rosacea

Although the lupus rash and rosacea can present with a bright red rash over the cheeks and nose, some features distinguish the conditions. Lupus is an autoimmune disease, whereas rosacea is an inflammatory condition that affects the skin on the face, whereas lupus can cause overall damage to organs. In addition, rosacea appears as blush or sunburn, whereas lupus can present with a butterfly rash on the face, but rashes can also appear on other parts of the body. 

Discoid lupus vs SLE

Discoid lupus erythematosus (DLE) is a chronic condition that can lead to scarring of the skin. It is the most common form of cutaneous lupus. It is characterised by skin lesions or sores that can affect the face and scalp. Although there is no cure for discoid lupus, treatment can help keep the symptoms in check. 

When to Consult A Doctor

Chronic conditions are a true challenge. If you are experiencing lupus symptoms, you must remain in touch with a doctor to manage the symptoms and improve your quality of life. You can chat with our online doctor at Your Doctors Online and discuss your condition.

Do you have lupus? Chat with our online doctor to determine the best treatment plan

FAQs About Lupus Answered By Your Doctors Online Team

How does a person get lupus?

The exact cause of lupus has not been identified. Although, genetics, hormones and environmental factors have shown a close association in the development of the disease. 

What does lupus do to a person?

If you have lupus, you might experience joint pain, skin sensitivities and rashes, and issues with internal organs (brain, lungs, kidneys and heart)

What are the 11 signs of lupus?

According to the American College of Rheumatology, a patient must display at least four of the eleven symptoms for a lupus diagnosis.
A butterfly-shaped rash or malar rash on the face.
Skin rash/patches
Sensitivity to light
Ulcers or sores in the mouth and nose
Arthritis/swelling of the joints
Seizures or symptoms that indicate that the nervous system has been affected
Presence of excessive protein in the urine
Inflammation of the heart or lungs
Low blood cell counts
Presence of specific antibodies in the blood
Positive ANA test 

Does lupus show up in blood work?

A single blood test or imaging study cannot provide a definite diagnoses for lupus. A complete blood count is done to determine the number and type of red blood cells, white blood cells, and platelets in the blood. Other tests ordered include a C-reactive protein test, erythrocyte sedimentation rate, and an antinuclear antibody test. 

What organ does lupus affect the most?

Kidney involvement is very common with SLE. Lupus is known to cause serious damage to the kidneys. 

Is lupus a terminal illness?

Although lupus is an incurable disease, it is not fatal unless an individual develops severe life-threatening complications. Studies have shown that 80% to 90% of people with this condition will likely live an average life span.

What is the life expectancy for lupus?

The life expectancy of lupus is dependent on multiple factors. Mainly it depends on the disease’s severity and the treatment response. However, most people diagnosed with lupus can expect a normal life expectancy. 

Does stress cause lupus?

Stress can trigger flare-ups in people who have the condition. Stressful events can make symptoms worse as well.

Is lupus curable?

Currently, there is no cure for lupus. However, treatment options are available that aim to control your symptoms to limit the amount of damage the disease does to your body. The condition can be managed to the extent that the individual may still have a normal life.

What should lupus patients avoid?

Some things that a person with lupus should avoid include:
Sunlight
Garlic
Alfalfa Sprouts
Echinacea
Medications such as Bactrim and Septra

What is the most serious type of lupus?

Systemic lupus erythematosus (SLE) is the most serious type of lupus. SLE affects multiple systems of the body, causing widespread complications. 

Does lupus make you pee a lot?

​​Lupus nephritis results in kidney inflammation. This can, in turn, lead to frequent urination. 

Does lupus get worse with age?

Although, the severity of the disease can vary from individual to individual. It has been noticed that with age, lupus disease activity often declines. 

How long can you have lupus without knowing?

Lupus symptoms can be vague. Normally, it can take up to six years for people with lupus to be diagnosed, from the time they initially notice their symptoms. 

What does lupus do to the eyes?

Lupus can affect the skin around the eyelids and lead to dry eyes. Moreover, it can result in inflammation of the white outer layer of the eyeball(scleritis), changes in the blood vessel in the retina, and damage to nerves controlling eye movement, consequently affecting vision. 

How long does a lupus rash last?

The rash can linger on for a few days to weeks.

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