Lupus: What Is, Symptoms, Causes & Treatment

Medical review: Dr. Arthur Frazão
Opthalmologist
May 2022
  1. Symptoms
  2. Diagnosis
  3. Causes
  4. Types
  5. Treatment

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

Lupus, or 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 first symptoms, especially when there is a flare-up of symptoms from an 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.

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:

  • Fever over 37.5ºC (99.5ºF);
  • Red butterfly-shaped rash on the face;
  • Red patches on other parts of the body, especially those exposed to the sun;
  • Painful mouth and nose sores and lesions;
  • Muscle sore and stiffness;
  • Joint pain and swelling;
  • Hair loss;
  • Sensitivity to light;
  • Fatigue;
  • Convulsions with no apparent cause.

These symptoms usually occur during a flare-up, i.e., they appear intensely for a few days or weeks and then they 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.

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?

How To diagnose lupus

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 4 main types, according to it's characteristics, symptoms, and possible causes. These are:

  • Systemic Lupus Erythematosus (SLE), is the most common type, in which various parts and organs of the body become swollen, especially the skin, joints, heart, kidneys, and lungs. Symptoms vary depending on the affected areas. 
  • Discoid Lupus or Cutaneous Lupus, in which there are only lesions on the skin, not affecting other organs. Some patients with discoid lupus, however, may develop systemic lupus as time goes on.
  • Medication-Induced Lupus, which is more common in men and happens due to a temporary inflammation from an extensive use of certain types of medication, such as hydralazine, procainamide, and isoniazid. Usually, symptoms disappear a few months after the medication is terminated;
  • Neonatal Lupus, which is one of the rarest types of lupus, but can happen in babies who are born from women who have lupus.

It's important that the type of lupus be identified by a rheumatologist or dermatologist so that adequate treatment can be started.

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 to take some precautions such as applying sunblock everyday and having other healthy lifestyle habits.

It's also recommended to adopt an anti-inflammatory type of diet, in order to prevent the appearance of symptoms or to decrease their intensity. To do this, it's recommended that you increase your consumption of foods rich in antioxidants and omega-3, such as salmon, tuna, green tea, onion, broccoli, avocado, and tomato. Learn more on how to maintain an anti-inflammatory diet.

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Atualizado por Tua Saude editing team, em May de 2022. Medical review por Dr. Arthur Frazão - Opthalmologist, em September de 2021.

References

  • SCUTTI, Jorge Augusto B. Fundamentos da Imunologia. São Paulo: Rideel, 2016. 195-199.
  • NHS. Lupus. Available on: <https://www.nhs.uk/conditions/lupus/>. Access in 03 Nov 2020
Show more references
  • CDC. Lupus Basics. Available on: <https://www.cdc.gov/lupus/basics/index.html>. Access in 03 Nov 2020
  • SOCIEDADE BRASILEIRA DE REUMATOLOGIA. Lúpus Eritematoso Sistêmico (LES). Available on: <https://www.reumatologia.org.br/doencas-reumaticas/lupus-eritematoso-sistemico-les/>. Access in 11 May 2021
  • LUPUS FOUNDATION OF AMERICA. What is lupus?. Available on: <https://www.lupus.org/resources/what-is-lupus>. Access in 03 Nov 2020
Medical review:
Dr. Arthur Frazão
General practitioner
General practitioner, who completed at a specialty ophthalmology at the UFRN in 2008. Licensed to practice under CRM-PE license #16878.