Lupus

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What Is Lupus?

Lupus is a long-term autoimmune condition in which the immune system mistakenly attacks healthy tissues. This causes inflammation that may affect the joints, skin, kidneys, heart, lungs, blood cells or nervous system.

Symptoms vary greatly between people. Lupus often alternates between flares, when symptoms become more active, and remission, when symptoms improve or disappear. The most common form is systemic lupus erythematosus, or SLE.

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What Causes Lupus?

The exact cause of lupus is not fully understood. It is thought to develop through a combination of genetic susceptibility, immune-system changes and environmental influences.

Possible triggers include sunlight, infections, smoking and certain medicines. However, these factors do not cause lupus in everyone, and the condition is not the result of something a person did.

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Types of Lupus

Systemic lupus erythematosus is the most common type and can affect several organs and body systems.

Cutaneous lupus mainly affects the skin and may cause rashes, sores or sensitivity to sunlight. Its forms include discoid and subacute cutaneous lupus.

Drug-induced lupus is a reaction to certain medicines. Symptoms usually improve after the responsible medicine is stopped under medical supervision.

Neonatal lupus is a rare condition affecting some babies whose birth parent has particular antibodies. It is different from systemic lupus and is usually temporary, although it can occasionally affect the baby’s heart.

How Is Lupus Treated?

Treatment is personalized according to the symptoms, organs affected and severity of the condition. Its goals are to control inflammation, reduce flares, prevent organ damage and support quality of life.

Medicines may include anti-inflammatory treatments, antimalarial medicines, corticosteroids, immunosuppressants and biologic treatments. Additional medicines may be needed to manage complications such as high blood pressure, blood clots or reduced bone strength. Treatment should not be stopped or changed without speaking to the healthcare team.

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Living With Lupus

Regular appointments and blood and urine tests are important even when symptoms are controlled. Tracking pain, fatigue, rashes, fever, swelling, medicines and the effect of symptoms on daily life can help patients prepare for appointments.

Sun protection may be especially important because ultraviolet light can trigger skin symptoms or wider disease activity in some people. Balanced nutrition, appropriate physical activity, enough rest and avoiding smoking can also support general health, although they do not replace medical treatment.

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How Lupus Can Affect the Organs

Lupus inflammation may affect the kidneys, causing a condition called lupus nephritis. Warning signs can include protein or blood in the urine, swelling, high blood pressure or changes in kidney function, although kidney inflammation may initially cause no noticeable symptoms.

Lupus can also affect the lining around the heart or lungs, the blood vessels, blood-cell counts and the nervous system. Some people develop antiphospholipid antibodies, which can increase the likelihood of blood clots. Regular blood and urine tests help identify organ involvement before serious symptoms develop.

Risks

Anyone can develop lupus, although it is considerably more common in women and often begins between adolescence and middle age. People with a close relative who has lupus or another autoimmune condition may have a greater likelihood of developing it.

Lupus is also diagnosed more frequently in people of African, Asian, Hispanic, Indigenous American and Pacific Islander ancestry. Having one or more risk factors does not mean that someone will necessarily develop lupus.

Symptoms

Common symptoms include severe fatigue, painful or swollen joints, morning stiffness, fever, hair loss and mouth or nose sores. Skin symptoms may include a rash across the cheeks and nose, circular scaly patches or rashes that become worse after sun exposure.

Other possible symptoms include headaches, memory or concentration difficulties, swollen glands, abdominal discomfort and fingers or toes changing color in response to cold or stress. Swelling around the eyes or in the legs, chest pain when breathing deeply and changes in urination may indicate that internal organs are affected. Symptoms can appear gradually, come and go, and change over time.

Diagnosis

There is no single test that can confirm lupus. Diagnosis is based on a person’s symptoms, medical and family history, physical examination and laboratory results. Because symptoms may appear at different times and resemble other conditions, reaching a diagnosis can take time.

Testing may include an antinuclear antibody test, more specific antibody tests, blood-cell counts, kidney-function tests and urine tests. A skin or kidney biopsy may be recommended when those organs appear to be affected. A positive antinuclear antibody result alone does not mean that someone has lupus.