Lupus erythematosus Symptoms

  • Symptoms

    Early lupus symptoms such as fatigue and joint pain often mimic other diseases. Lupus symptoms such as fatigue and pain are frequently vague, and can be attributed to other problems. Symptoms may come and go, and it is difficult to predict how long a flare of symptoms will last.

    A classic symptom of lupus is a “butterfly” facial rash Figure 01. Doctors in the 1800s named the disease lupus, meaning “wolf,” because they thought the hallmark facial rash looked like the bite of a wolf. The rash is red or pink, and it can be raised or flat. It generally covers both cheeks and crosses the nose. It may extend to the chin and ears. While this rash has led to the disorder's name, it only occurs in 20% of patients. Rashes may also appear on the arms, hands, chest, or other areas exposed to the sun.

    Click to enlarge: Lupus “butterfly” facial rash

    Figure 01. Lupus “butterfly” facial rash

    Almost all patients experience joint pain and arthritis-like symptoms. Lupus may cause joint problems similar to rheumatoid arthritis, which makes hands feel stiff, painful, and inflamed with redness, warmth, or swelling. An x-ray does not show much damage to your joints; however, you may still feel considerable pain.

    People with lupus often feel extremely tired. The fatigue felt by lupus patients is not the normal tiredness you might feel after physical exertion or exercise. Patients often describe it is as being “bone-tired,” like the kind you feel with a bad case of the “flu” or with mono. It is a deep exhaustion that rest may not relieve.

    Other symptoms include fever, sun sensitivity with the development of a rash or flare, hair loss, mouth or nose ulcers, chest pains caused by breathing, weight loss or gain, leg swelling, and seizures.

    Elevated blood pressure or swelling ankles may indicate associated kidney problems. Kidney inflammation, called nephritis, is seen in half of people with lupus. Nephritis may not produce symptoms, so regular blood and urine tests help monitor kidney function.

    Some patients develop seizures and other brain- and nerve-related symptoms. Lupus can cause neurological or psychiatric changes that can make you forgetful. You may complain about difficulty concentrating, a short attention span, headaches, dizziness, or vision problems, as well as depression. These problems can also be caused or worsened by medication or stress.

    People with lupus may experience seizures, or may be more susceptible to strokes. Problems with the ability to think or remember well may also occur. If the blood vessels in the eyes are inflamed (vasculitis), it can lead to blindness within a few days. Immediately report any neurologic or vision problems to the doctor. Symptoms of this condition are sudden blurriness of vision that doesn’t go away, although sometimes this condition is not accompanied by any symptoms.

    Additional symptoms occur if lupus affects other parts of the body. If inflammation occurs in the heart or lungs, you may experience chest pain or shortness of breath. If the digestive tract is affected, then nausea, vomiting, diarrhea, and abdominal pain may occur. Lupus can also cause changes in the number and type of blood cells in the bloodstream. For example, a decrease in the red blood cells causes anemia, so be alert to such symptoms as fatigue, palpitations, shortness of breath, and pale skin. Blood cell changes also make some patients at risk for blood clots, bleeding, or infections.

  • Risk Factors

    A family history of autoimmune diseases is one risk factor. Autoimmune diseases tend to run in families. If you have lupus, your family members may be prone to developing lupus or another autoimmune disorder, such as rheumatoid arthritis, thyroid disease, or type 1 diabetes mellitus. While this genetic risk is real, it is small (less than 1 in 50).

    Immediate relatives (sister, brother, parent, child) of people with lupus are at greater risk than the general population.

    Lupus is more common in younger women and non-Caucasians. Women are nine times more likely than men to develop lupus. The disease typically begins during the childbearing years, between the ages of 15 and 45. Lupus occurs four times more often in African-American women than in Caucasians. It is also more common in Hispanics, Asians, and Native Americans.

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