What are the Most Common Symptoms of Lupus?
Lupus is a chronic autoimmune disease that can affect just about any system in the body. Known as "the great imitator," it is famously difficult to diagnose. In fact, diagnosis can often take up to six years after the first onset of symptoms, because lupus symptoms often look a lot like something else.
Let's take a look at the most common symptoms of lupus and how they tend to present, so you can begin to narrow down whether or not you might be dealing with the autoimmune condition.
An overview of lupus
Lupus is a chronic autoimmune condition in which certain organs of the body, such as the joints, skin, kidneys, blood cells, brain, heart and lungs, begin to attack their own tissue, leading to damage and inflammation. The vast majority of people with lupus are women of childbearing age.
Although lupus is incurable and can lead to irreversible physical damage if left untreated, the condition can be managed with medication and lifestyle changes.
An in-depth look at common symptoms
"The most difficult part of lupus and other autoimmune diseases is the diagnosis," said Ken Perry, M.D., an emergency doctor in Charleston, South Carolina. "It is very difficult to diagnose lupus since many of the symptoms are general and nonspecific. To have a definitive diagnosis of lupus requires a blood test that looks for the antibodies that target the person's own cells. This is normally done by a rheumatologist or a primary care physician."
Nevertheless, by paying close attention to your symptoms and discussing them with your doctor, patterns may begin to emerge and you may find yourself one step closer to a diagnosis.
Here is a look at how symptoms of lupus tend to present themselves in most people:
Joint pain and arthritis
Pain in the joints is a very common symptom of lupus. In fact, arthritis occurs in up to 95 percent of people with systemic lupus erythematosus (SLE), the most common type of lupus. Most people find that joint pain occurs primarily in the hands and the wrists. This type of joint pain is often the first sign of lupus.
Muscle pain and swelling
Muscle pain, also known as myalgia, and muscle swelling, or myositis, can occur in people with lupus as a result of inflammation of the joints. As the Centers for Disease Control and Prevention (CDC) noted, pain and swelling affect most people with lupus in the neck, thighs, shoulders and upper arms. Myalgia is thought to affect roughly half of all SLE cases, while myositis is fairly rare.
Fever is a common early symptom of a new case of lupus or a lupus flare-up. However, fevers can occur for a wide variety of other reasons, so it's a fairly nonspecific symptom and is usually inconclusive. According to a 2011 review, fever that occurs alongside other lupus symptoms such as weight loss, joint pain and fatigue may be a sign of the condition.
Weight loss or weight gain
Over time, lupus can lead to unhealthy weight loss due to a loss of appetite or muscle loss. Weight gain is also a common side effect of both the disease and certain medications such as steroids, which are often prescribed for lupus.
Some types of lupus affect only the skin, but all kinds of lupus can lead to skin-related symptoms. Common symptoms are a red, dry rash that usually occurs after exposure to the sun, a butterfly-shaped red rash on the face, or round sores that appear on the face and scalp. In some cases, lupus can also lead to hair loss and mouth ulcers.
If your case of lupus affects the lungs, you may experience chest pain. Lupus can lead to pleuritis or pneumonitis, which are both types of inflammation of the lung tissue. Over time, these conditions can damage and scar the lungs, affecting your breathing in the long term.
Over time, SLE can result in kidney disease and even kidney failure. About half of all adults with lupus eventually experience kidney disease, while it occurs in 80 percent of childhood cases of lupus. Signs of kidney problems might include foamy urine, fever, a red rash, muscle pain, and swelling of the legs, feet or ankles.
Fatigue, or tiredness that doesn't go away after a good night's sleep, occurs in around 81 percent of lupus cases. For 40 percent of people with lupus, fatigue can be severe and long term.
Jessica Berman, M.D., a rheumatologist at the Hospital of Special Surgery (HSS) in New York City, defined lupus fatigue as "an overwhelming, sustained sense of exhaustion and decreased capacity for mental and physical work."
People with lupus may feel more fatigued after light activity.
Anemia, which occurs when there is a lack of healthy red blood cells in the body, appears in roughly half of all cases of SLE, according to a 2006 study. Anemia can lead to fatigue, weakness, dizziness and cold hands and feet.
Unfortunately, there's no easy way to know if you have lupus without visiting your doctor and discussing your symptoms. Your doctor may also wish to take blood tests to reach a diagnosis.
"Lupus, like many other autoimmune diseases, is sometimes very frustrating for patients because they have many symptoms that do not seem to fit neatly into one diagnosis," Perry said. "They can feel that they are not being believed and that their care is not being prioritized. It is helpful to have a relationship with a primary care physician who can help guide and facilitate care."
If you're experiencing some of the common lupus symptoms, visit a doctor and establish a relationship so you can begin the process of getting a diagnosis.