Symptoms vary from person to person and even with the same person from time to time. The most common signs are:
- A butterfly-shaped rash across the bridge of the nose and cheeks or a scaly, disk-shaped rash on the face, neck or chest
- Sensitivity to sunlight. People with lupus often experience severe rashes or sunburns after only a little time in the sun.
- Skin ulcers, usually painless, on the tongue or inside the mouth or nose
- Arthritis. Persons with the condition may experience joint pain, stiffness and swelling.
- Inflammation of the linings of organs such as the heart and lungs (serositis) that makes breathing painful or causes shortness of breath or chest pain.
- Kidney problems, such as inflammation, either without symptoms or accompanied by swelling of the legs, and high blood pressure.
- Brain or spinal cord problems, accompanied by headaches, seizures or mental problems.
A person may also experience:
- Fatigue along with dizziness, headaches or depression
- Unexplained fever, which may be an early sign of lupus
- Raynaud's phenomenon, in which fingers, toes, nose and ears turn pale and numb when exposed to cold
- Chest pain that may be accompanied by coughing
- Swelling of glands, legs or the area around the eyes
- Digestive problems, including loss of appetite, nausea, diarrhea and weight loss
- Unusual hair loss.
- Depression or trouble concentrating. This is either a result of the disease or a reaction to living with a chronic disease.
If lupus is not treated or controlled, these complications can result:
- Inflamed kidneys, which may cause no pain but can be detected with urine and blood tests. A blood test is used to check kidney function.
- Central nervous system problems, such as headaches, dizziness, difficulty concentrating, mood swings or seizures
- Blood and blood vessel problems. These include anemia, increased risk of bleeding, increased risk of blood clots or inflamed blood vessels.
- Inflammation of the lungs and the linings of the chest cavity. This can make breathing painful and increase the risk of a form of pneumonia.
- Chest pain resulting from inflammation of the heart muscle, arteries or heart membrane. The leading cause of death for people with lupus today is cardiovascular disease, which can lead to heart attacks. It is not clear whether this is because people with lupus are living longer or whether it is a complication of treatment. Exercising, not smoking, controlling high blood pressure and reducing cholesterol levels all help reduce the risk of cardiovascular disease.
- Infection, from having the disease and from treatment
- Tissue death, caused when the blood supply to certain areas is reduced. The hip joint is commonly affected and may result in pain when walking.
For women who are of the age to bear children, lupus creates special risks, including:
- Difficulty conceiving. Flare-ups of the disease and medications used to treat it can contribute to infertility.
- Greater risk for miscarriage. The risk is highest early or late in the pregnancy. The risk can be reduced by careful planning and medical care.
- More risk of complications during pregnancy. Flare-ups are more likely. The risk for high blood pressure, diabetes and kidney problems during pregnancy is also higher.
- Limited birth control options. Women may not tolerate birth control pills well, and they should not use intrauterine devices because of the risk of infection.
Causes and Risk Factors for Lupus
The exact cause of lupus is unknown. Many doctors believe that a combination of factors (including genetic heritage, the environment and hormones) leads to its development. While lupus itself is not inherited, it is possible that some combinations of genes make a person more likely to develop the condition. A virus or bacterial infection may then cause the disease to develop.
Although anyone can develop lupus at any age, it mostly affects women in the childbearing years. Common risk factors include:
- Gender. Women are about nine times more likely than men to develop lupus.
- Race. African Americans are three to four times more likely than Caucasians to develop the disease.
- Family history. Having a relative who has lupus increases the odds.
- Pregnancy. Lupus sometimes shows up for the first time during pregnancy or shortly after giving birth.