Signs and Symptoms of Lupus

Lupus is an autoimmune condition that causes inflammation in the body. Most people with lupus experience extreme fatigue and body pain, among other symptoms.

Lupus is a chronic (long-lasting) autoimmune disease. When a person has an autoimmune disease, their immune system attacks healthy cells or tissues by mistake, which can cause inflammation throughout the body.

Lupus can affect any part of the body, including the muscles, joints, skin, heart, kidney, lungs, and blood. These symptoms range from mild to severe and look different from person to person. Because each case of lupus is so different, your individual symptoms can range from affecting just one part of your body to all parts of your body.

woman sitting on couch with coffee mug looking fatigued

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General Symptoms 

Although lupus symptoms look different from person to person, there are some common symptoms that most people experience with this condition. General symptoms of lupus include:

  • Disabling fatigue 
  • Lack of energy
  • Fever 
  • Unintentional weight loss due to stomach issues OR unintentional weight gain due to water retention

People with lupus may have periods of increased symptoms called flares or flare-ups. They may also experience periods when their lupus symptoms are reduced or not as active, which is referred to as remission. Lupus flares can happen at any time which makes it difficult for people to manage their condition.  

Musculoskeletal Symptoms

The musculoskeletal system is made up of muscles, bones, joints, and the tissues that connect these parts of the body together. If you experience musculoskeletal symptoms, you may have pain in your neck, thighs, shoulders, and upper arms.

Typically, joint-related symptoms are the first to appear when you have lupus. You might experience pain, swelling, and inflammation in your joints. These symptoms tend to happen in your hands or wrists at first. But, you can also experience symptoms in any of your joints.

Lupus-related joint symptoms tend to mimic inflammatory arthritis conditions like rheumatoid arthritis (RA) or psoriatic arthritis (PsA). Unlike RA and PsA, lupus-related arthritis tends to have more pain than swelling and rarely asymmetrical leads to joint deformities. However, it is important to note that many people living with lupus can also develop RA down the line.

Dermatologic Symptoms

Many people with a lupus diagnosis develop dermatologic (or, skin) symptoms as their condition progresses. A “butterfly rash” (or, clinically called “acute cutaneous lupus erythema”) is a skin rash that occurs on the face—specifically on the cheeks and nose. A butterfly rash appears after sun exposure and lasts from a few days to weeks. The rash can sometimes be painful.

Other lupus-related skin symptoms include, but are not limited to:

  • Rashes or skin inflammation caused by light sensitivity 
  • Discoid lesions, or disk-shaped wounds and scars that develop on areas of your skin that have been exposed to the sun
  • Nonscarring alopecia, which causes patchiness and hair loss on parts of the scalp

Cardiovascular Symptoms

People with lupus can also experience cardiovascular (or, heart) symptoms. These symptoms can appear in the heart’s membrane, muscles, and blood vessels.

You may experience lupus-related heart conditions, such as:

  • Pericarditis: Inflammation in the sac-like membrane layer (or, pericardium) that covers the heart 
  • Myocarditis: Inflammation of the heart muscle (or, myocardium)
  • Vasculitis: Inflammation of the blood vessels, which can also affect the arteries and veins

Renal Symptoms

More than half of people living with lupus experience renal (or, kidney) symptoms. Although kidney symptoms can vary from person to person, it is a significant cause of disability and death in people with this condition. Because of this, healthcare providers may use various lab tests to screen for lupus nephritis—a lupus-caused condition that leads to inflammation in the kidneys. 

Symptoms of lupus nephritis may include:

  • Hematuria: Blood in the urine
  • Proteinuria: Protein in the urine 
  • Glomerulonephritis: Inflammation of the tiny filters in the kidneys (called the glomeruli)

Pulmonary Symptoms 

Pulmonary symptoms of lupus affect the lungs and other parts of the respiratory system. The respiratory system is made of organs and tissues that help you breathe. Lupus-related lung symptoms include:

  • Pleuritis: Pain in the chest or shoulders due to inflammation of the pleura, or thin layers of tissue that separate your lungs from the chest wall 
  • Interstitial lung disease: A group of lung disorders that cause scarring of the lungs  
  • Pulmonary hypertension: High blood pressure in the blood vessels that carry blood from the heart to the lungs 

Hematologic Symptoms

Hematologic symptoms involve your blood, bone marrow, lymph nodes, and spleen. Anemia of chronic disease (also known as anemia of inflammation) is the most common type of anemia seen in people living with lupus.

Anemia is a condition that occurs when you have a lack of healthy red blood cells to help you carry oxygen to different parts of the body. 

Leukopenia, a condition where there are few white blood cells, also occurs in about 50% of people with lupus. The condition can cause enlarged lymph nodes and an enlarged spleen, especially during an active lupus flare. 

When to See a Healthcare Provider 

Lupus symptoms can mimic symptoms of other health conditions. That’s why diagnosis can be difficult. If you begin to experience any of the above lupus symptoms—especially if you have unexplained fatigue or joint pain—it’s a good idea to talk to your healthcare provider about getting tested. 

No single test can determine if a person has lupus. Your healthcare provider will likely use a variety of measures, including an intake of your personal medical and family history, physical exam, and lab tests to help reach a lupus diagnosis or rule out other conditions. The sooner you get tested, the earlier you can begin treatment to reduce symptoms and improve your overall quality of life.

A Quick Review 

Lupus is a chronic, autoimmune disease that can affect different parts of the body. The inflammation that lupus causes can cause pain and other uncomfortable symptoms in your joints, muscles, skin, heart, kidneys, lungs, and blood. 

Not everyone with lupus has the same symptoms, as lupus is a condition that each person experiences uniquely. There are also periods of increased symptoms called flare-ups and periods of reduced symptoms called remission. 

Because lupus affects several parts of the body, the condition can be difficult to diagnose at first. If you begin to notice possible symptoms of lupus, it’s good practice to reach out to your healthcare provider. They can help you get tested, rule out other conditions, reach an official diagnosis, and get you started on proper treatment as soon as possible. 

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  2. MedlinePlus. Lupus

  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Systemic lupus erythematosus (lupus).

  4. Wallace DJ, Gladman DD. Clinical manifestations and diagnosis of systemic lupus erythematosus in adults. In: Post TW. UpToDate. UpToDate; 2022

  5. Centers for Disease Control and Prevention. Lupus symptoms

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Lupus and kidney disease (lupus nephritis).

  7. Centers for Disease Control and Prevention. Diagnosing and treating lupus

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