Lupus symptoms vary from patient to patient, so each patient may have a variety of the following symptoms:
extreme Fatigue
The most common feature of lupus is fatigue. It is a major symptom in some patients and can be very distressing. The cause of this fatigue is still poorly understood, but generally, energy levels seem to improve once the disease is brought under control. Gentle exercise on a regular basis is helpful as is weight loss although both can be difficult to maintain long term.
Joint Aches and Pains
Flu like symptoms are common in lupus patients and are a major feature of the disease. Sometimes joint pains can be severe, mimicking early rheumatoid arthritis but normally the joints are not damaged and this clearly differentiates lupus from rheumatoid arthritis.
Hair Loss
Hair loss is an important feature of lupus and is often the first sign of a disease flare. In the majority of patients the hair grows back totally once the disease is brought under control.
Depression
This is a major feature of lupus and very common indeed. It often requires both treatment of the lupus itself as well as the depression. Read our article on depression here.
Mouth ulcers
Mouth ulcers area common feature of lupus and can also appear in the nose and vagina.
Dry (scratchy) eyes & dry mouth
Many patients with lupus also have “secondary Sjögren’s syndrome” with poor tear and saliva secretion. This results in irritation of the eyes and in some patients quite marked dryness. This is usually helped by artificial tears.
Dryness of the mouth is also common and is helped by frequent sips of water and chewing sugar-free gum.
Sensitivity to sunlight
Lupus can make your skin extremely sensitive to sunlight and other types of UV light. Exposure to UV rays can trigger flares of lupus symptoms, including skin rashes, joint pain, fatigue and even fevers.
Skin Rashes
These can affect any part of the body, the most well-known being the so called “butterfly rash” over the cheeks and the bridge of the nose. In many patients the rash is made worse by exposure to ultra-violet light e.g. sunlight.
Classic lupus butterfly rash.
FEVER
A fever with no other cause or explanation is a common symptom of lupus. Fevers can occur when the disease flares and can be a first sign of lupus.
Night sweats
Excessive sweating, especially night sweats, commonly occurs with autoimmune diseases such as lupus. Night sweats can be accompanied by fevers.
Chest pain
Pain when taking a deep breath or lying down from inflammation of the lining of the lungs and the heart is common. Inflammation of the tissue that surrounds the lungs, making it painful to breathe is called pleurisy. Pain arising from inflammation of the lining around the heart is called pericarditis.
Inflammation of Tissues covering internal organs
The thin “sausage-skin” covering internal organs such as the heart (pericardium) and lungs (pleura) can be inflamed leading to painful symptoms such as pleurisy.
Heart problems
Lupus can cause a number of heart problems, including heart attacks, strokes, heart valve disease and inflammation of the heart muscle known as myocarditis. This is because lupus damages the heart's lining and blood vessels.
Swollen glands
Swollen lymph nodes in the neck, armpits, or groin often occurs with lupus flares.
Weight changes
Lupus can cause weight loss or weight gain, which can be due to the disease itself, its treatments, or a person's lifestyle. A common cause of weight gain is prednisolone which is used to treat the inflammation due to lupus.
Back Pain
This can be a symptom of lupus due to inflammation, kidney involvement or a medication side effect.
Raynaud’s Phenomenon
Fingers or toes that turn white when exposed to cold or during stressful periods.
Headaches, dizziness, depression, confusion, memory problems or seizures
Due to changes in the brain and central nervous system. Other symptoms include tingling and pins and needles from nerve inflammation.
Myositis
Lupus can cause muscle inflammation with muscle pain and weakness.
Blood clots & pregnancy problems
Patients with lupus may also have antiphospholipid syndrome (APS). This autoimmune condition is associated with blood clots such as strokes, heart attacks and deep vein thrombosis. Another aspect of APS is recurrent pregnancy problems including miscarriages and premature deliveries.
Kidney Problems
The kidney is the “silent” organ and often patients do not know that the kidney is involved. It is common practice in our unit to teach patients to test their own urine (using “dip sticks”). Urine testing is essential in lupus patients for the early detection of kidney involvement, for which treatment must be prompt to prevent kidney damage.
