• Symptoms of Systemic Lupus Erythematosus

    The symptoms of lupus vary from mild to extremely severe and debilitating. In some patients, only one part of the body—for example, the skin—is affected. In others, many parts of the body are affected. Each case is unique in the symptoms that it produces. Though symptoms of lupus can be chronic, they usually flare up and subside intermittently.
    Common symptoms (occurring in at least 4 out of 5 patients) include:
    • Swollen and/or painful joints—Usually the smaller joints of the hands and feet are affected. They may just hurt, or they may actually become inflamed.
    • Fever—A lupus fever is just a degree or two above normal, but is enough to make you feel ill.
    • Extreme fatigue, loss of appetite, weight loss—These are signs of chronic illness.
    • Skin rashes (especially on the nose and cheeks)—Most patients have one of two skin rashes, either a facial rash or characteristic red patches on sun-exposed areas.
    Butterfly Rash on the Face
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
    Other signs and symptoms of lupus may include:
    • Hair loss—This is a fairly common symptom of lupus. The hair loss is usually patchy.
    • Chest pain and difficulty breathing—These are signs that your heart or lungs may be affected by lupus and can indicate serious problems.
    • Kidney inflammation—You may not have symptoms of kidney inflammation, but it can be identified through urine and blood tests. Kidney disease is one of the most dangerous components of lupus.
    • High blood pressure —High blood pressure can be due to inflammation of blood vessels (vasculitis) or advanced kidney disease. You won't have any symptoms, but high blood pressure can and must be treated.
    • Anemia or other blood disorders—Blood disorders may be due to the direct effects of the disease on the blood and blood-forming elements, or may be a result of advanced kidney or vascular disease. These disorders make you feel tired easily.
    • Sensitivity to sunlight —This is a peculiarity of the effects of lupus on your skin. You'll need to stay out of the sun.
    • Raynaud's phenomenon —This phenomenon entails reduced circulation to the fingers, especially in the cold, which causes them to ache and to turn red, white, and blue.
    • Swelling around the eyes—This type of swelling is a sign of kidney disease.
    • Swollen glands—Lymph glands, such as those in the neck, are the battlefields of your immune system. They swell when your immune system is fighting off an infection or other condition.
    • Headaches—These occur for many reasons. If you have lupus, you should notify your doctor.
    • Dizziness—If you have lupus, this could be a sign of low blood pressure or a direct effect of lupus on your brain. The symptom should not be ignored; talk to your doctor if you have dizziness.
    • Seizures —If you have lupus, this is a sign that lupus may be affecting your brain. If you have a seizure, call your doctor immediately.
    • Stroke —If you have lupus, a stroke is a serious sign that lupus is affecting your brain, regardless of the severity of the stroke.
    • Inflammation of the heart, heart vessels, or membrane surrounding the heart —If you have lupus, inflammation of the heart can lead to many different consequences, depending on which organs end up with a decrease in blood supply. Symptoms may include shortness of breath, chest pain, irregular heart beat, or lightheadedness.
    Lupus may also cause complications during pregnancy, such as:
    • In the woman: flare-up of symptoms, inflammation of the kidneys, pre-eclampsia (high blood pressure during pregnancy)
    • In the baby: premature birth , miscarriage , intrauterine growth restriction (baby does not grow properly in the womb), stillbirth

    References

    Fauci A. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

    Ferri F, ed. Ferri’s Clinical Advisor 2010. Philadelphia, PA: Mosby Elsevier; 2009.

    Firestein G, Kelley W. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia, PA: Saunders; 2008.

    Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

    Lupus Foundation of America website. Available at: http://www.lupus.org .

    5/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Smyth A, Oliveira GH, Lahr BD, Bailey KR, Norby SM, Garovic VD. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol. 2010;5(11):2060-2068.

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