What Happens When You Have Lupus?

Lupus is an autoimmune disease that occurs when your immune system begins to attack your own tissues and organs, resulting in these 12 common symptoms.

Lupus is an autoimmune disease, which means that your immune system begins to dysregulate itself and attacks your own organs.

Lupus symptoms vary from person to person, and the disease can range from mild to life-threatening.

The 12 common symptoms of lupus include:

1. Joint and muscle pain or swelling
2. Prolonged fatigue
3. Low-grade fever of unknown origin
4. Skin rash, often on the face, which is called the “butterfly rash”
5. Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud’s phenomenon)
6. Shortness of breath
7. Dry eyes, eye rash, and iritis (eye pain)
8. Headache, confusion, or memory loss
9. Chest pain
10. Unusual hair loss
11. Anemia
12. Sensitivity to sunlight

Lupus can affect many parts of your body and can lead to complications.

Inflammation caused by lupus can affect the following organs:

• Kidneys: Lupus can severely damage the kidneys, and kidney failure is one of the leading causes of death in people with lupus.
  • Symptoms include:
    • Inability to pass urine
    • Pass frothy urine
    • Facial edema
    • Nausea
    • Vomiting
    • Leg swelling or edema
• Brain and central nervous system:
  • Lupus can cause:
    • Headache
    • Dizziness
    • Behavioral changes
    • Hallucinations
    • Strokes
    • Seizures in the brain
    • Memory problems (people with lupus may struggle to express themselves)
• Blood and blood vessels:
  • Lupus can cause blood issues such as:
    • Anemia
    • Increased risk of bleeding or blood clotting
    • Vasculitis (blood vessel inflammation)
• Lungs:
  • Lupus increases your risk of pleurisy, an inflammation of the lining of the chest cavity that can make breathing difficult.
  • People with lupus might be more prone to pneumonia.
• Heart:
  • Lupus can inflame the heart muscle, arteries, or heart membrane (pericarditis).
  • People with lupus are at a high risk of cardiovascular disease and heart attack.

Having lupus increases your risk of:

• Infection:
  • People with lupus are more susceptible to infection because the disease and its treatment both can weaken the immune system.
  • Lupus increases your risk of cancer; however, the risk is small.
• Bone tissue death:
  • This occurs when blood supply to a bone decreases, often leading to tiny breaks in the bone and, eventually, bone collapse.
• Pregnancy complications:
  • Infertility
  • Miscarriage
  • Preterm birth and high blood pressure

Doctors frequently advise deferring pregnancy until your disease has been under control for at least six months to reduce the risk of these complications.

Lupus is difficult to diagnose because signs and symptoms vary so much from person to person. The diagnosis is made based on the results of blood and urine tests, signs and symptoms, and physical examination findings.

There are two types of lupus, with significant differences in the type and severity of symptoms:

1. Systemic lupus erythematosus (SLE):
   • The disease is characterized by flare-ups and periods of improvement (remissions), and it can affect almost any organ or system of the body.
   • Most people with lupus are only affected by the skin and joints. SLE can affect the kidneys, lungs, heart, blood vessels, and/or brain in some people.
2. Discoid lupus (also known as chronic cutaneous lupus erythematosus):
   • An SLE-like rash appears as a red scaly rash on sun-exposed areas such as the face, scalp, arms, legs, or trunk.
   • The majority of people with discoid lupus have only skin symptoms. However, only a small percentage of people with discoid lupus develop SLE.

Other milder forms of lupus include:

• Subacute cutaneous lupus:
  • The most common symptoms are skin rash, sun sensitivity, and joint pain.
• Drug-induced lupus:
  • This is typically a transient form that develops as a reaction to certain medications and resolves when the medications are discontinued.

Lupus has no known cause; however, because it is an autoimmune disorder, a combination of genetic and environmental factors contributes to the formation of antibodies that cause lupus.

People who have an inherited proclivity for lupus may develop the disease if they come into contact with something in the environment that can trigger lupus.

In most cases, the cause of lupus is unknown; however, potential triggers include:

• Sun exposure may cause lupus skin lesions or elicit an internal response in people who are predisposed to it.
• Infections can trigger immune dysregulation that manifests as lupus or cause a relapse in some people.
• Certain blood pressure medications, anti-seizure medications, and antibiotics can trigger lupus.
• When people with drug-induced lupus stop taking the medication, they usually get better.
• In rare cases, symptoms may persist even after the drug has been discontinued.

Factors that may increase your risk of lupus include:

• Female sex
• Age between 15 and 45 years
• African American, Hispanic, and Asian American ethnicities

Lupus treatment is determined by your signs and symptoms.

Determining whether you should be treated and which medications to take necessitates a careful discussion with your doctor of the benefits and risks. You and your doctor may need to change medications or doses as your signs and symptoms flare and subside.

The following medications are most commonly used to treat lupus:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs):
   • Over-the-counter NSAIDs can be used to treat lupus-related pain, swelling, and fever. Prescription-only NSAIDs are also an available option.
2. Antimalarial drugs:
   • Antimalarial medications affect the immune system and can help reduce the risk of lupus flare-ups. When you take these medications, you must have regular eye exams.
3. Corticosteroids:
   • Prednisone and other corticosteroids can help reduce lupus inflammation.
   • High doses of steroids are frequently used to treat serious kidney and brain disease.
   • With higher doses and longer treatment duration, the risk of side effects increases.
4. Immunosuppressants:
   • Drugs that suppress the immune system may be helpful in serious cases of lupus.
5. Biologics:
   • They are a type of medication that is administered intravenously and reduce lupus symptoms in some people.

• NSAIDs can cause stomach bleeding, kidney problems, and an increased risk of heart problems.
• Side effects of antimalarial drugs may include stomach upset and, in rare cases, retinal damage.
• Weight gain, easy bruising, thinning bones, high blood pressure, diabetes, and an increased risk of infection are possible side effects of corticosteroids.
• Potential side effects of immunosuppressants include an increased risk of infection, liver damage, decreased fertility, and an increased risk of cancer.
• Biological drugs can cause nausea, diarrhea, infections, and, rarely, depression.

If you have lupus, you should take steps to care for your body. Simple precautions can help you avoid flare-ups; however, if they do occur, these precautions can also help you cope with the signs and symptoms more effectively.

Regular checkups, rather than only seeing your doctor when your symptoms worsen, may help your doctor prevent flare-ups and can be useful in addressing routine health concerns. Stress, diet, and exercise can help prevent lupus complications.

Availability of better medications has changed the outlook of people with lupus. Referral to a doctor as soon as possible makes a significant difference. Delays in the treatment can result in organ failure and death.