What’s Lupus? Symptoms, Causes, Treatment & Risk

Last updated on February 19th, 2023 at 07:13 pm

10 minutes read.     

Overview

Lupus is a disease that occurs when your body’s immune system attacks your own tissues and organs (autoimmune disease).

Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart, and lungs.

If you have lupus, you may experience periods of illness (flares) and periods of wellness (remission). Lupus flares can be mild to serious, and they are unpredictable.

However, with treatment, many people with lupus can manage the disease.

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments.

The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus.

Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs, or even sunlight. While there’s no cure for lupus, treatments can help control symptoms. (1)

In this article:

What’s Lupus? Types

Symptoms , Causes , Treatment

common lupus medications

Risk factors , Complications

Prevention ,  FAQ , Conclusion

What’s Lupus?

Systemic lupus erythematosus (SLE), commonly referred to simply as lupus, is a chronic autoimmune disease that can cause swelling (inflammation) and pain throughout your body.

When you have an autoimmune disease, your body’s immune system fights itself. The immune system is supposed to fight possible threats to the body — infections, for example — but, in this case, it goes after healthy tissue. (1, 2)

If you have lupus, you might experience joint pain, skin sensitivities and rashes, and issues with internal organs (brain, lungs, kidneys, and heart).

Many of your symptoms might come and go in waves — often called flare-ups. At times, symptoms of lupus might be mild or not noticeable (meaning they’re in remission).

Other times, you could experience severe symptoms of the condition that heavily impact your daily life. (3, 4)

Types of Lupus

When people talk about lupus, they’re usually talking about systemic lupus. But there are four kinds of lupus:

1. Systemic lupus erythematosus is the most common

2. Cutaneous lupus erythematosus: This type of lupus affects the skin — cutaneous is a term meaning skin.

Individuals with cutaneous lupus erythematosus may experience skin issues like sensitivity to the sun and rashes. Hair loss can also be a symptom of this condition.

3. Drug-induced lupus: These cases of lupus are caused by certain medications. People with drug-induced lupus may have many of the same symptoms of systemic lupus erythematosus, but it’s usually temporary.

Often, this type of lupus goes away once you stop the medication that’s causing it.

4. Neonatal lupus: A rare type of lupus, neonatal lupus is a condition found in infants at birth.

Children born with neonatal lupus have antibodies that were passed to them from their mother — who either had lupus at the time of the pregnancy or may have the condition later in life. Not every baby born to a mother with lupus will have the disease. (5, 6)

Sign and Symptoms

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent.

Most people with lupus have mild disease characterized by episodes — called flares — when signs and symptoms get worse for a while, then improve or even disappear completely for a time.

The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include:

• Fatigue
• Fever
• Joint pain, stiffness, and swelling

• A butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
• Skin lesions that appear or worsen with sun exposure
• Fingers and toes that turn white or blue when exposed to cold or during stressful periods.
• Shortness of breath
• Chest pain
• Dry eyes
• Headaches, confusion, and memory loss. (7,8,9,10)

When should you see a doctor?

See your doctor if you develop an unexplained rash, ongoing fever, persistent aching, or fatigue

Causes

What are the causes of lupus?

The cause of lupus is currently unknown. Researchers are still working to learn more about the reason lupus happens.

Even though the exact cause isn’t known, there are factors that may play a role in the condition.

Possible factors that could cause lupus can include:

• Hormonal changes: Women are more likely to experience lupus than men and this could be partly due to hormones like estrogen.

Lupus is often seen in women during their reproductive years (ages 15 to 44) when estrogen levels are higher.

• Environmental factors: Different aspects of your environment can also increase your risk of having lupus.

• Sunlight

Factors like the amount of sunlight you’re exposed to, medications you take, viruses you might have been exposed to, or even stress, can all be possible causes of lupus.

• A history of smoking can also be a possible cause of lupus.

• Your family history: There may be a genetic factor to lupus. If you have family members who have lupus, your risk of the disease is increased. (7,8,9,10,11, 12)

Treatment

How is lupus treated?

The way your health provider treats lupus can depend on several factors, including:

The symptoms and complications you are experiencing.

• The severity of your case.
• Your age.
• The type of medications you may be taking.
• Your general health.
• Your medical history.

Lupus is a life-long (chronic) condition that will needed to be managed regularly. The goal of treatment is to get your symptoms into remission (not active) and limit the amount of damage the disease does to your organs.

Unfortunately, lupus is unpredictable, and the way the condition impacts you can shift and change over time. You will need to regularly visit your healthcare provider and adapt your care plan to match your symptoms.

Some people with mild features of lupus might require limited treatment. These individuals may have symptoms that are monitored and watched to make sure they do not get worse, but they aren’t currently in need of treatment.

Others may need an aggressive treatment plan. These individuals tend to have more serious complications (like heart, lung, or kidney complications).

Your healthcare provider will discuss the best treatment options with you based on your symptoms, complications, and medical history. (4,13, 14)

What are common lupus medications?

Medications that can be used to treat lupus include:

1.Steroids (corticosteroids, including prednisone): Steroid creams can be directly applied to rashes. The use of creams is usually safe and effective, especially for mild rashes.

 The use of steroid creams or pills in low doses can be effective for mild or moderate features of lupus. Steroids can also be used in higher doses when internal organs are threatened. Unfortunately, high doses are also most likely to produce side effects.

2. Hydroxychloroquine (Plaquenil®): This medication is commonly used to help manage mild lupus-related problems, such as skin and joint disease. It’s also used to treat fatigue and mouth sores.

3. Azathioprine (Imuran®): A medication originally used to prevent rejection of transplanted organs, this is commonly used to treat the more serious features of lupus.

4. Methotrexate (Rheumatrex®): This medication is another chemotherapy drug that’s used to suppress the immune system.

Its use is becoming increasingly popular for skin disease, arthritis, and other non-life threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.

5. Cyclophosphamide (Cytoxan®) and Mycophenolate mofetil (CellCept®): These medications are chemotherapy drugs that have very powerful effects on reducing the activity of the immune system.

They are used to treat more severe forms of lupus, especially lupus that affects the kidneys.

6. Belimumab (Benlysta®): This medication is a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies.

Autoantibodies are important as they cause tissue damage. Belimumab is used to treat lupus that does not involve the kidneys and has not responded to other types of treatments.

7. Rituximab (Rituxan®): This medication is also a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies. It’s sometimes used to treat lupus that has not responded to other types of treatments. (4,15,16)

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Diagnosis

How is lupus diagnosed?

The diagnosis process can be long and difficult for lupus. The symptoms that you might experience with lupus can overlap with those of other conditions — for example, diabetes and arthritis.

Symptoms of lupus may also take time to develop, adding to the challenge of diagnosing the disease.

Your healthcare provider will typically start with a family history to see if lupus runs in your family. Then, your provider will want to discuss any symptoms you’ve experienced.

After talking to you about your symptoms, your provider will typically do some lab tests. These tests are looking for things like low blood cell counts, anemia, and other abnormalities.

The provider may also do an antinuclear antibody (ANA) test. This test looks for antibodies — proteins in your body that defend against disease — that could be a sign you have an autoimmune disease.

People who have systemic lupus erythematosus usually test positive for ANAs.

Does a positive antinuclear antibody (ANA) test mean I have lupus?

Testing positive for antinuclear antibodies alone does not mean you have lupus. The ANA test is positive in most people with lupus, but it’s also positive in many people who do not have lupus.

Because of this, a positive ANA alone isn’t enough to diagnose you with lupus. Your provider will typically look for at least three other clinical features (including symptoms and family history) before making a diagnosis of Lupus. (4,5, 17, 18)

Risk factors

Factors that may increase your risk of lupus include:

• Your sex: Lupus is more common in women.
• Age: Although lupus affects people of all ages, it’s most often diagnosed between the ages of 15 and 45.
• Race: Lupus is more common in African Americans, Hispanics, and Asian Americans. (19,20, 21)

Complications

Inflammation caused by lupus can affect many areas of your body, including your:

Kidneys: Lupus can cause serious kidney damage, and kidney failure is one of the leading causes of death among people with lupus.

Brain and central nervous system: If your brain is affected by lupus, you may experience headaches, dizziness, behavior changes, vision problems, and even strokes or seizures.

 Many people with lupus experience memory problems and may have difficulty expressing their thoughts.

Blood and blood vessels: Lupus may lead to blood problems, including a reduced number of healthy red blood cells (anemia) and an increased risk of bleeding or blood clotting. It can also cause inflammation of the blood vessels.

Lungs: Having lupus increases your chances of developing an inflammation of the chest cavity lining, which can make breathing painful. Bleeding into the lungs and pneumonia also are possible.

Heart: Lupus can cause inflammation of your heart muscle, your arteries, or the heart membrane. The risk of cardiovascular disease and heart attacks increases greatly as well.

Other types of complications

Having lupus also increases your risk of:

Infection: People with lupus are more vulnerable to infection because both the disease and its treatments can weaken the immune system.

Cancer: Having lupus appears to increase your risk of cancer; however, the risk is small.

Bone tissue death: This occurs when the blood supply to a bone declines, often leading to tiny breaks in the bone and eventually to the bone’s collapse.

Pregnancy complications: Women with lupus have an increased risk of miscarriage. Lupus increases the risk of high blood pressure during pregnancy and preterm birth.

To reduce the risk of these complications, doctors often recommend delaying pregnancy until your disease has been under control for at least six months. (22, 23 24, 25)

Prevention

How to prevent Lupus symptoms?

What can I do to prevent lupus flare-ups?

While lupus itself can’t be prevented, you can make changes to your daily life to help avoid flare-ups of your symptoms. A few things to try can include:

1.Avoiding sun exposure: For many with lupus, sun exposure can be an issue.

Try avoiding going outside during peak hours when the sun is out, wearing protective clothing (long sleeves and a brimmed hat), and wearing sunscreen.

2. Staying in motion: Joint pain can make you want to sit down and rest, but doing low-impact exercises can actually help.

3. Maintaining healthy habits: A few habits to keep in mind include making healthy choices when it comes to your food, getting plenty of sleep, and cutting back on the stress in your life.

There is also a strong link between lupus and heart disease. Make sure you are working with your healthcare team to reduce your risk of heart issues. (26, 27, 28)

FAQ (Frequently Asked Questions)

Is lupus more common in women?

Lupus is much more common in women, with nine out of 10 cases happening in women. Often, women are diagnosed between the ages of 15 and 44 — during their reproductive years.

Even though the cause of lupus is unknown, it’s thought that the hormone estrogen may play a part in the condition.

What does lupus do to the body?

Lupus can impact many different parts of your body. It can cause aches and pains, as well as serious complications to your major organs.

Because lupus is an autoimmune disease, it causes your body to attack itself. This can lead to organ damage over time.

What is the lupus rash?

A skin rash is one common symptom of lupus. Rashes from lupus are often from prolonged sun exposure, and usually last days to weeks. You can have a rash on your face, hands or wrists.

When you have a rash on your face, it typically extends across the bridge of your nose and onto each of your cheeks. This is often referred to as a “butterfly rash” because of the shape across your face.

Skin rashes can be uncomfortable and itchy. These rashes can sometimes fade after a short period of time. However, some rashes and sores on your skin can be permanent.

Why does lupus cause hair loss?

One of the complications of lupus can be damage to your skin and hair loss. People with lupus can develop scarring on their skin and scalp from rashes. This can cause your hair to thin and fall out.

You could also experience hair loss as a side effect of some medications that treat lupus — hair loss can be a side effect of steroids. If your hair is thinning or falling out, talk to your healthcare provider.

Sometimes, changing your medications can help with this issue. Your provider might also recommend using gentle shampoos (baby shampoo).

Why does lupus cause weight gain or weight loss?

Many people with lupus may experience weight loss. This can be caused by the medications that are used to treat lupus or by the discomfort of the disease itself.

On the flip side, some people may gain weight if they find that they are inactive due to joint pain. It’s important to maintain a healthy diet when you have lupus.

Talk to your healthcare provider — and possibly a nutritionist (a food specialist) — to determine the best diet for you.

Can lupus be cured?

There’s currently no cure for lupus. Treatment of lupus is focused on managing your symptoms and limiting the amount of damage the disease does to your body. The condition can be managed to minimize the impact lupus has on your life, but it will never go away.

Can you die from lupus?

In most cases, death wouldn’t be caused directly by lupus, but by the symptoms and damage to organs. Issues like kidney damage, cardiovascular disease, and infections can cause serious harm and be life-threatening.

Is lupus contagious?

Lupus is not contagious and cannot be passed from one person to another by touch, sneeze, or cough

Can I get pregnant if I have lupus?

Women with lupus can get pregnant. However, there is a risk of poor pregnancy outcomes (miscarriage) in people with lupus.

If you’re considering a future pregnancy, start talking to your healthcare provider several months in advance during a preconception appointment.

 Your provider may need to adjust your lupus medications to ensure that they’re safe for pregnancy.

If I have lupus, will I pass it on to my children?

There can be a genetic factor to lupus. Your risk of having lupus increases if you have other family members with the condition. A mother with lupus can pass it on to her child.

However, this doesn’t always happen, nor does it happen often. Some women with lupus deliver a baby with the condition, while others do not.

If you have a family history of lupus or have lupus yourself and are thinking about getting pregnant, talk to your healthcare provider.

Conclusion

Lupus is a disease that occurs when your body’s immune system attacks your own tissues and organs (autoimmune disease).

Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart, and lungs.

The exact cause isn’t known, but certain factors may play a role in the condition:

Hormonal changes, Environmental factors, Sunlight, and Your family history

Lupus can be treated using certain drugs such as Steroids, Hydroxychloroquine (Plaquenil®), Azathioprine (Imuran®), Methotrexate (Rheumatrex®), Cyclophosphamide (Cytoxan®) and Mycophenolate mofetil (CellCept®) Belimumab (Benlysta®), Rituximab (Rituxan®).  

Lupus itself can’t be prevented, you can make changes to your daily life to help avoid flare-ups of your symptoms. A few things to try can include:

• Avoiding sun exposure
• Staying in motion
• Maintaining healthy habits

A mother with lupus can pass it on to her child but in rare cases. Lupus is not contagious either.

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