Symptoms of Lupus
General information about symptoms of Lupus: The symptom information on this page attempts to provide a list of some possible symptoms of Lupus. This symptom information has been gathered from various sources, may not be fully accurate, and may not be the full list of symptoms of Lupus. Furthermore, symptoms of Lupus may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of symptoms and whether they are indeed symptoms of Lupus.
List of symptoms of Lupus: The list of symptoms mentioned in various sources for Lupus includes:
- Some of the most common symptoms are:
- Skin symptoms
- Arthritis (joint problems)
- Kidney problems
- Neurological disorders
- Behavioral symptoms
- Raynaud's phenomenon - see symptoms of Raynaud's phenomenon:
- Finger numbness
- Cold sensitivity in fingers
- Weight loss
- Hair loss
- Abdominal discomfort
- Chest pain from deep breaths
- Abdominal pain
- Episodic flares and remissions
- Poor finger circulation
- Poor toe circulation
- Leg swelling
- Swelling around eyes
- Repeated miscarriages
- Cardiovascular disease
- Enlarged spleen
- Enlarged lymph nodes
- Patchy hair loss
- Brain symptoms
Symptoms of Lupus: Typical features of lupus include a butterfly shaped rash over the cheeks, a skin rash appearing in areas exposed to the sun, sores in the mouth and nose, arthritis involving one or more joints, kidney inflammation, neurological disorders such as headaches, personality changes, organic brain syndrome, peripheral neuropathies, sensory neuropathy, psychological problems including paranoia, mania, and schizophrenia, seizures, transverse myelitis, and paralysis and stroke. Fever, weight loss, hair loss, poor circulation in the fingers and toes, chest pain when taking deep breaths, and abdominal pain may also occur. 1
The signs of lupus differ from person to person. Some people have just a few signs; others have more.
Common signs of lupus are:
- Red rash or color change on the face, often in the shape of a
butterfly across the nose and cheeks
- Painful or swollen joints
- Unexplained fever
- Chest pain with deep breathing
- Swollen glands
- Extreme fatigue (feeling tired all the time)
- Unusual hair loss (mainly on the scalp)
- Pale or purple fingers or toes from cold or stress
- Sensitivity to the sun
- Low blood count
- Depression, trouble thinking, and/or memory problems
Other signs are mouth sores, unexplained seizures (convulsions), "seeing things" (hallucinations), repeated miscarriages, and unexplained kidney problems.
What Is a Flare?
When symptoms appear, it's called a "flare." These signs may come and go. You may have swelling and rashes one week and no symptoms at all the next. You may find that your symptoms flare after you've been out in the sun or after a hard day at work.
Even if you take medicine for lupus, you may find that there are times when the symptoms become worse. Learning to recognize that a flare is coming can help you take steps to cope with it. Many people feel very tired or have pain, a rash, a fever, stomach discomfort, headache, or dizziness just before a flare. 2
Although people with the disease may have many different symptoms, some of the most common ones include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes, and kidney problems. 3
Each personís experience with lupus is different, although there are patterns that permit accurate diagnosis. Symptoms can range from mild to severe and may come and go over time. Common symptoms of lupus include painful or swollen joints, unexplained fever, and skin rashes, along with extreme fatigue. A characteristic skin rash may appear across the nose and cheeks--the so-called butterfly or malar rash. Other rashes occur elsewhere on the face and ears, upper arms, shoulders, chest, and hands.
Other symptoms of lupus include chest pain, hair loss, sensitivity to the sun, anemia (a decrease in red blood cells), and pale or purple fingers and toes from cold and stress. Some people also experience headaches, dizziness, depression, or seizures. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times.
Common Symptoms of Lupus
In some people with lupus, only one system of the body such as the skin or joints is affected. Other people experience symptoms in many parts of their body. Just how seriously a body system is affected also varies from person to person. Most commonly, joints and muscles are affected, causing arthritis and muscle pain. Skin rashes are quite common. 3
Patients with systemic lupus erythematosus most commonly experience profound fatigue, rashes, and joint pains. In severe cases, the immune system may attack and damage several organs such as the kidney, brain, or lung. For many individuals, symptoms and damage from the disease can be controlled with available anti-inflammatory medications. However, if a patient is not closely monitored, the side effects from the medications can be quite serious.4
Fever, weight loss, hair loss, mouth and nose sores, malaise, fatigue, seizures and symptoms of mental illness. Ninety percent of patients experience joint inflammation similar to rheumatoid arthritis. Fifty percent develop a classic "butterfly" rash on the nose and cheeks. Raynaud's phenomenon (extreme sensitivity to cold in the hands and feet) appears in about 20 percent of people with SLE. 5
Lupus is characterized by periods of illness (flares) and periods of wellness (remission). It is difficult to diagnose because it is often mistaken for other diseases. The following are some common symptoms of lupus:
- Extreme fatigue
- Painful or swollen joints (arthritis)
- Unexplained fever
- "Butterfly" rash across the nose and cheeks that is characteristic to
- Skin rashes on other parts of the body
- Chest pain or pleurisy (inflammation of the pleura, the membrane that
covers the lungs)
- Kidney problems
- Unusual loss of hair
- Pale or purple fingers from cold or stress
- Sensitivity to the sun
- Low red blood-cell count
- Mouth or nose ulcers
- Cardiovascular disease
Some people also experience headaches, dizziness, or depression. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times.
How Is Lupus Diagnosed?
Early diagnosis and treatment are needed to improve health and reduce tissue damage. Diagnosing lupus can be difficult, however, because it may take months or even years for doctors to piece together the symptoms to make an accurate diagnosis. Giving the doctor a complete, accurate medical history is critical to the process of diagnosis. This information, along with a physical examination and the results of laboratory tests, helps the doctor rule out other diseases that may mimic lupus. Reaching a diagnosis may take time and occur gradually as new symptoms appear.
What Are the Treatments for Lupus?
Because each person's symptoms are different, doctors treat lupus on an individual basis. Once lupus has been diagnosed, the doctor will develop a treatment plan based on the patient's age, gender, health, symptoms, and lifestyle. Tailored to the individual's needs, this plan may change over time. In developing a treatment plan, the doctor has several goals: to prevent flares, to effectively treat them when they do occur, and to minimize complications. The doctor and patient should reevaluate the plan regularly to ensure that it is as effective as possible.
Treatment for lupus includes physical and emotional rest, protection from direct sunlight, a healthful diet, exercise, prompt treatment of infections, avoidance of known allergens and aggravating factors, and medication when necessary. The medication the doctor chooses is based on the patient's individual symptoms and needs. For people with joint pain, fever, and swelling, drugs that decrease inflammationCnonsteroidal anti-inflammatory drugs (NSAIDs)Care often used. Antimalarials are another type of drug commonly used to treat lupus. They may be used alone or in combination with other drugs to treat fatigue, joint pain, skin rashes, and inflammation of the lungs. Corticosteroid hormones are the mainstay of lupus treatment. Related to cortisol, which is a natural anti-inflammatory hormone, corticosteroids work by rapidly suppressing inflammation. Because they are potent drugs, the doctor will seek the lowest dose with the greatest benefit.
Working closely with the doctor helps ensure that treatments for lupus are as successful as possible. Because some treatments may cause harmful side effects, it is important to promptly report any new symptoms to the doctor.
It is also important not to stop or change treatments without talking to the doctor first. With early diagnosis and the correct treatment and medication, most people with lupus can maintain an overall high quality of life.
SOURCES: National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH Publication No. 93-3219; Lupus Foundation of America.
Department of Health and Human Services Activities on Lupus
Office on Women's Health (OWH) within the Department of
Health and Human Services (DHHS) is the Federal government's focal point for
women's health issues. OWH works to improve women's health by coordinating
women's health research, health care services, policy, and public and health
care professional education across the agencies of the DHHS; and collaborating
with other government organizations, and consumer and health care professional
Phone: (202) 690-7650;
National Women's Health Information Center (NWHIC), a service of OWH, is a national resource for information on women's health. Through NWHIC, the public and health professionals can access the vast array of Federal and other sources of women's health information.
Phone: 1-800-994-WOMAN (1-800-994-9662);
National Institutes of Health (NIH) is the Federal focal
point for biomedical research in the United States. The goal of NIH is to
acquire new knowledge to help prevent, detect, diagnose, and treat disease and
disability. Within NIH, the National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) and the National Institute of Nursing Research (NINR)
conduct and support research on lupus.
Phone: (301) 496-4000;
NIAMS of the NIH leads the Federal medical research effort in arthritis and musculoskeletal and skin diseases. NIAMS supports research and research training throughout the United States as well as on the NIH campus in Bethesda, MD. The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse (NAMSIC) is a public service sponsored by NIAMS that provides health information.
Phone: (301) 495-4484; TTY: (301) 565-2966;
NIAMS has recently produced a manual entitled LUPUS: A Patient Care Guide for Nurses and Other Health Professionals to help health professionals who work with lupus patients to improve their care and quality of life. The guide covers symptoms and diagnosis, advances in lupus research, lab tests for diagnosis and evaluation, lupus medications, health care interventions for general and system-specific manifestations of lupus, psychosocial aspects, and information resources.
National Institute of Nursing Research (NINR), a component of NIH, supports research and research training in universities, hospitals, research centers, and at NIH in areas related to health promotion and disease prevention, managing the symptoms and disabilities of illness, and improving the environment in which patient care is delivered. Chronic diseases, such as lupus and arthritis, are among the six major areas of emphasis for the Institute.
Phone: (301) 496-0207;
The signs of lupus vary and may have periods of exacerbation and remission. Some people have just a few signs of the disease; others have more. Many people with lupus look healthy. Lupus may be hard to diagnose and is often mistaken for other diseases. For this reason, lupus has often been called the "great imitator." Common signs of lupus include red rash or color change on the face, often in the shape of a butterfly across the bridge of the nose and the cheeks; painful or swollen joints; unexplained fever; chest pain with breathing; unusual loss of hair; pale or purple fingers or toes from cold or stress; sensitivity to the sun; and low blood count. These signs are more important when the occur together. Other signs of lupus can include mouth sores, unexplained fits or convulsions, hallucinations or depression, repeated miscarriages, and unexplained kidney problems. 7
More symptoms of Lupus: In addition to the above information, to get a full picture of the possible symptoms of this condition and its related conditions, it may be necessary to examine symptoms that may be caused by complications of Lupus, underlying causes of Lupus, associated conditions for Lupus, risk factors for Lupus, or other related conditions.
Medical articles on symptoms: These general reference articles may be of interest:
1. excerpt from NINDS Neurological Sequelae Of Lupus Information Page: NINDS
2. excerpt from The Many Shades of Lupus: NIAMS
3. excerpt from Handout on Health Systemic Lupus Erythematosus: NIAMS
4. excerpt from Understanding Autoimmune Disease: NIAID
5. excerpt from Connective Tissue Diseases: NWHIC
6. excerpt from Lupus Fact Sheet: NWHIC
7. excerpt from Lupus: NWHIC
Last revision: June 2, 2003
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