Lupus: Types, Symptoms, Complications, Diagnosis and Treatment

Lupus is a chronic autoimmune disease: the immune system attacks healthy cells and tissues by mistake, causing inflammation that can damage many parts of the body — joints, skin, kidneys, heart, lungs and brain.

Types

Causes and who gets it

The cause is unknown. Researchers are studying possible causes and triggers: genetics; environmental factors such as viral infections, sunlight, certain medicines and smoking; and immune system problems.

Anyone can get lupus, but women get it much more often than men. It is more common in African Americans than in White people, and also more common in people of American Indian and Asian descent. African American and Hispanic women are more likely to have severe forms.

Symptoms

Symptoms vary from person to person. Common ones include:

• arthritis — painful, swollen joints and morning stiffness
• fever and fatigue
• a red rash, most often on the face — the "butterfly rash"
• chest pain on deep breathing
• hair loss
• pale or purple fingers or toes in cold or stress (Raynaud phenomenon)
• sun sensitivity
• swelling in the legs or around the eyes
• mouth ulcers and swollen glands
• headache, dizziness, confusion and memory problems

Symptoms come and go. A period of symptoms is a flare, and flares range from mild to severe; new symptoms can appear at any time.

Complications

Inflammation throughout the body can cause:

• kidney damage (lupus nephritis)
• heart problems — inflammation of the heart (myocarditis), its valves, or its lining (pericarditis)
• inflamed blood vessels (vasculitis) and blood clots
• inflammation of the tissue around the lungs (pleurisy), which makes breathing painful

Some people with lupus are also more likely to develop coronary artery disease and atherosclerosis.

Diagnosis

There is no single test, and lupus is often mistaken for other diseases, so diagnosis can take time. Your provider will ask about your symptoms and medical and family history, do a full physical exam, and may order blood tests — such as ANA (antinuclear antibody), other antibodies, a complete blood count and complement tests — urine tests, and skin or kidney biopsies.

Treatment

There is no cure, but medicines and lifestyle changes can control it. You will likely see a primary care provider — who should coordinate your care — and a rheumatologist, plus other specialists depending on what lupus affects (for example, a cardiologist for the heart). You and your provider will make a treatment plan and review it often; report new symptoms right away.

The goals: prevent flares, treat flares when they happen, limit organ damage, and improve quality of life. Medicines may reduce fever, swelling and pain, reduce inflammation, prevent flares, protect the joints, and suppress the immune system. Newer medicines target specific parts of the immune system for some types of lupus, including lupus affecting the kidneys. You may also need treatment for related problems such as high cholesterol, high blood pressure or infections.

Research has not clearly shown that alternative or complementary therapies help lupus — talk to your provider before trying any. Researchers are studying treatments such as CAR-T cell therapy for lupus that has not responded to other medicines; such treatments are usually available only through research studies until approved.

Living with lupus

Take an active role in your treatment. Learning to spot the warning signs of a flare can help you prevent it or make it milder. Find ways to handle stress — exercise and relaxation help — and lean on a good support system.

Sources

Based on "Lupus," MedlinePlus, National Library of Medicine, with its summary from the National Institute of Arthritis and Musculoskeletal and Skin Diseases; a work of the United States government in the public domain.