Lupus: Symptoms, Diagnosis, Causes, Types & Treatment

Lupus is an autoimmune disease that causes the defense cells of the immune system to attack other healthy cells in the body. This leads to wide-spread inflammation that can affect the joints, skin, eyes, kidneys, brain, heart and lungs.

Lupus, also known as systemic lupus erythematosus,  is more common in women between 14 and 45 years old, with symptoms appearing soon after birth. However, it is very common for the disease to only be diagnosed several years after the onset of symptoms, especially when there is a flare-up of symptoms that is thought to be from another infection, some type of medication, or when there is excess exposure to the sun.

Even though lupus has no cure, there are some treatment options that can be prescribed to relieve symptoms and improve quality of life. These treatments may include anti-inflammatory medication, corticosteroids, and immunosuppressants.

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Main symptoms

Lupus can affect any organ of the body, and therefore symptoms can vary greatly from one person to another. Even so, some common symptoms include:

  • Red patches on the skin, with a particularly characteristic butterfly-shaped rash on the face or other places exposed to the sun
  • Greater sensitivity to light
  • Fever and general malaise
  • Weight loss and abdominal pain
  • Hair loss
  • Blurry vision
  • Ulcers in the mouth or throat
  • Joint pain or inflammation
  • Mental health changes, such as depression or psychosis
  • Kidney disease, such as glomerulonephritis, also called lupus nephritis

These symptoms usually occur as flare-up, i.e., they appear intensely for a few days or weeks and then disappear again. But there are also cases in which symptoms are constant.

Sometimes lupus symptoms can be similar to other more frequent conditions, such as diabetes or arthritis, and so it's possible for the diagnosis to take longer, as your doctor will need to rule out other conditions. Read more about lupus symptoms that you may experience.

Online lupus symptom checker

Enter your symptoms below to assess your risk for lupus. 

  1. 1. Red patches shaped like butterfly wings on the face, nose or cheeks?
  2. 2. Red spots on the skin that peel and heal, leaving a scar?
  3. 3. Skin spots that appear after exposure to sunlight?
  4. 4. Small painful sores in the mouth or inside the nose?
  5. 5. Pain or swelling in one or more joints?
  6. 6. Episodes of convulsions or mental alterations with no apparent reason?

Confirming a diagnosis

To confirm the diagnosis of Lupus, in addition to assessing all signs and symptoms, your rheumatologist may also prescribe some blood and urine tests.

The main changes that may indicate lupus in the tests are:

  • Excess amount of protein in various urine tests;
  • Decrease in the number of erythrocytes, or red blood cells, in the blood tests;
  • Leukocyte count of less than 4.000/mL in the blood test;
  • Decrease in the number of blood platelets in at least two blood tests;
  • Lymphocytes levels of less than 1.500/mL in the blood test;
  • Presence of anti-double stranded DNA antibody or anti-Sm antibody in the blood test;
  • Antinuclear antibodies higher than usual in the blood test.

In addition, your doctor may also request other diagnostic tests such as an x-ray of the thorax or a kidney biopsy, to identify if there are inflammatory lesions in these organs that may be caused by lupus.

What causes lupus?

Lupus is a type of autoimmune disease, which are normally caused by genetic mutations during fetal development. Therefore, lupus is not a contagious disease that can be transmitted. 

Nevertheless, it is possible to be born without any symptom and then develop symptoms during adult life, due to factors that can stimulate the appearance of those symptoms, such as excessive sun exposure, viral infections, or the use of some types medication.

In addition, some people may also have a tendency to show the first signs of lupus during stages where hormonal alterations are common, such as puberty, pregnancy, or menopause. 

Types of Lupus

Lupus can be classified into different types, depending on the underlying cause and symptoms it presents with:

1. Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus (SLE) is characterized by inflammation in various parts and organs of the body, especially the skin, joints, heart, kidneys and lungs, causing spots on the skin exposed to the sun, joint symptoms such as arthritis, anemia, decreased blood cells. defense and platelets, and changes in the central nervous system, mainly.

2. Discoid or cutaneous lupus

Discoid or cutaneous lupus causes red plaques to appear only on the skin, particularly the scalp and face. It typically does not affect other organs, however, some people with discoid lupus may progress to systemic lupus over time.

3. Drug-induced lupus

Drug-induced or medication-induced lupus can lead to systemic lupus or discoid lupus, and occurs due to the use of certain medications, like hydralazine, procainamide or isoniazid. Inflammation is usually temporary and symptoms disappear after a few months after stopping the medication.

4. Neonatal lupus

Neonatal lupus is one of the rarest types of lupus, but it can happen in babies born to women with lupus.

Treatment options

Treatment for lupus must be guided by the type identified, symptoms presented, and the frequency of symptoms. Since there isn't a unique treatment capable of curing lupus, doctors usually prescribe a combination of medications that work to relieve symptoms, such as:

  • Anti-inflammatory medication, like naproxen or ibuprofen: used mainly when lupus causes symptoms of pain, swelling, or fever;
  • Antimalarial medication, such as chloroquine: helps avoid the development of lupus symptoms in some cases;
  • Corticosteroids, such as prednisone or betamethasone: reduce inflammation in affected organs;
  • Immunosuppressants, such as azathioprine or methotrexate: help decrease the action of the immune system and relieve symptoms. This type of medication can cause serious secondary effects such as recurrent infections or increased risk of cancer, and so they should only be used after a thorough medical evaluation.

In addition, it's also important for medications to be taken as prescribed by your rheumatologist, as a treatment plan for lupus can vary from person to person. This will ensure optimal quality of life and symptom control.

Is lupus curable?

There is no cure for lupus, however its symptoms can be controlled and prevented, as long as the doctor's instructions are followed.

Care during treatment

Some additional precautions may be recommended by the rheumatologist during lupus treatment to help relieve symptoms, such as getting adequate sleep, and avoiding direct sun exposure. You should always wear sunscreen and opt for  protective clothing, such as a hat , long-sleeved clothes or clothes that have a sun protection factor of SPF 40. 

It is also important to eat a healthy diet and to exercise regularly.