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What are the symptoms of lupus?

The most common symptoms of lupus are:

  • joint pains
  • skin rashes
  • extreme tiredness (fatigue).

Some people with lupus will only have these symptoms, though they can still have a big impact on daily life.

Other symptoms of lupus which can be quite common are:

  • fever
  • weight loss
  • swelling of the lymph glands. 

The common symptoms of lupus

Lupus can affect many different parts of the body, and when internal organs such as the heart, lungs, brain or kidneys are involved it can be much more serious. But most people will only have one or a few of the possible symptoms, and many people will find that the symptoms come and go.

Skin and mouth

It's common for a rash to develop over parts of the body that are exposed to the sun, including the face, wrists and hands. A butterfly-shaped rash over the cheeks and the bridge of the nose is especially common.

Some people with lupus notice that their fingers change colour in cold weather, going first very pale, then blue and finally red. This is called Raynaud's phenomenon and is caused by narrowing (constriction) of the blood vessels, which reduces the blood supply to the fingers or toes.

You may develop groups of mouth ulcers, which may come back repeatedly.

Hair

Some hair loss is common and can be severe in some people with lupus, but once a flare-up is brought under control the hair will usually grow back.

Joints

Joint pain is common in lupus, especially in the small joints of the hands and feet. The pain tends to move from joint to joint and is often described as 'flitting'.

Joint pain and swelling can be the main symptoms for some people, though lupus doesn't usually cause joints to become permanently damaged or deformed.

About 1 in 20 people with lupus develop more severe joint problems. Fewer than 1 in 20 have joint hypermobility or a form of arthritis called Jaccoud’s arthropathy, which can change the shape of the joints.

Kidneys

Around one in three people with lupus have significant inflammation of the kidneys, and kidney damage can sometimes occur. Kidney inflammation can be treated successfully in most patients if it's identified early with regular urine, blood pressure and blood testing by your doctor.

You must take any medication as prescribed by your doctor to make sure that your kidneys aren't permanently damaged.

Blood and blood vessels

Lupus can cause high blood pressure, particularly if the kidneys are involved. Steroid tablets, which are often used to treat lupus, can raise blood pressure particularly when used in high doses. Lupus can contribute to the development of high cholesterol, which should be checked yearly with a blood test and treated if necessary.

Lupus may also affect the bone marrow, causing amaemia and a reduction in the number of platelets (cells that help the blood to clot) and/or white blood cells. Blood-related problems like anaemia tend to be more common in children with lupus.

Some people with lupus are more at risk of developing blood clots in veins or arteries. This problem is usually caused by antiphospholipid antibodies. Some of these autoantibodies can also affect pregnancy, causing an increased risk of miscarriage (antiphospholipid syndrome).

Brain and nervous system

As many as one in three people with lupus may have migraines and may experience anxiety or depression. Some people have diziness, memory loss or confusion. Rarely, lupus can cause fits (similar to epilepsy) or feelings of paranoia (similar to schizophrenia) - though these complications only affect a small number of people with lupus.

Heart and lungs

Occasionally, lupus directly affects the heart and lungs. More often, it causes inflammation in the lining tissues around the heart (pericarditis) and lungs (pleurisy), both of which cause breathlessness and sharp pains in the chest. Rarely, large amounts of fluid develop in these lining layers, causing severe breathlessness.

More recently, we've found that lupus may also cause narrowing of the blood vessels. This can lead to increased risk of angina, heart attacks and strokes, so close monitoring and early treatment of factors such as high cholesterol and high blood pressure are vital.

Other organs

People with lupus can suffer swelling of the lymph glands, which may cause discomfort. 

Less frequently, lupus can affect the lining tissue of the gut (serositis), the gut, pancreas, liver or spleen, causing pain in the abdomen. Very rarely, lupus can affect the eyes, causing a painful red eye or changes in the eyesight.

Related conditions

About one third of people with lupus develop an additional autoimmune disease. Examples include autoimmune thyroid disease, in particular the type which makes the thyroid gland underactive.

Severe dryness of the eyes and mouth (Sjögren’s syndrome) occurs in about 10% of people with lupus, and rheumatoid arthritis or inflammation of your muscles (myositis) can develop, but these are much less common.

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