Understanding lupus

Lupus is an autoimmune disease that affects more than 1.5 million Americans, according to the Lupus Foundation of America. Normally, the immune system protects the body against foreign invaders like viruses and bacteria. In the case of a disease like lupus, the immune system mistakenly attacks the body and damages healthy tissues and organs. Lupus can cause problems with the kidneys, nervous system, blood vessels, and skin.

There are different types of lupus, each of which cause different symptoms. Systemic lupus erythematosus (SLE) is the most common type. It affects many different organs of the body, including the kidneys, lungs, brain, and arteries.

Cutaneous lupus erythematosus (CLE) affects the skin.

Neonatal lupus is a rare condition in pregnant women that causes the baby to be born with a rash, liver problems, and sometimes a heart defect.

People who have lupus often develop symptoms similar to that of the flu. They feel extremely tired. They have headaches and a fever, and their joints become swollen or painful. Because similar symptoms can occur with other diseases, such as arthritis, fibromyalgia, and thyroid problems, lupus can be difficult to diagnose. Its vague symptoms are also why lupus is sometimes called “the great imitator.”

More than 90 percent of people with lupus will experience joint pain and weakness, according to the Lupus Foundation of America. Most of that discomfort is caused by the inflammation that lupus triggers. Often people feel pain and stiffness in their joints, which is called lupus arthritis.

Lupus can also weaken muscles, especially in the pelvis, thighs, shoulders, and upper arms. Additionally, the disease can trigger carpal tunnel syndrome, which leads to pain and numbness in the hands and fingers.

Lupus that affects the skin (CLE) comes in different forms, and causes different types of rashes. Discoid lupus occurs in people with chronic cutaneous lupus (CCLE). It produces a coin-shaped red, scaly rash on the cheeks, nose, and ears. The rash doesn’t itch or hurt, but once it fades, it may leave the skin discolored. If the rash is on the scalp, hair loss may occur. Sometimes hair loss may be permanent.

In people with subacute cutaneous lupus (SCLE), the rash looks like scaly red patches or ring shapes. This rash usually appears on parts of the body that are exposed to sun, such as the arms, shoulders, neck, chest, and trunk. Having SCLE can make you more sensitive to the sun, so you need to be careful when going outside or sitting under fluorescent lights.

When systemic lupus flares up, you may notice a sunburn-like rash on your face. This “butterfly” rash is a sign of acute cutaneous lupus (ACLE). The rash is distinctive for its butterfly-like appearance: It spreads across the nose and fans out on both cheeks. This rash can also emerge on other parts of the body, especially those exposed to the sun, such as the arms, legs, and trunk. The ACLE rash is very sensitive to light.

Red blood cells transport oxygen-rich blood from the heart and lungs to the rest of the body. In lupus, the immune system can damage healthy red blood cells. This can cause a condition called hemolytic anemia. Having too few red blood cells can lead to symptoms such as fatigue, shortness of breath, dizziness, and a yellowish color to the skin and eyes (jaundice).

Some people with lupus have another problem with their blood. Normally, blood clots form when there is an injury to prevent the body from bleeding too much. In lupus, thrombosis may occur, causing clots to form where they’re not needed. This can be very dangerous, especially if a clot breaks off and gets lodged in a blood vessel of the lungs, brain, or other part of the body.

Lupus often attacks the nerves, which carry messages from the brain to the rest of the body. This damage can lead to a range of symptoms, including:

  • headaches
  • confusion
  • vision problems
  • mood swings
  • dizziness
  • numbness


When lupus attacks nerves to the hands and feet, it can cause Raynaud’s phenomenon, which causes the tips of the fingers or toes to turn red, white, or blue. Fingers and toes may also feel numb or painful in response to cold.

When lupus attacks the lungs, it can cause trouble breathing. If the membrane around the lungs becomes inflamed (pleurisy), it puts pressure on the lungs, which makes breathing painful. Lupus can also lead to pulmonary hypertension, a form of high blood pressure in which the blood vessel connecting the heart to the lungs thickens. Because less blood can travel from the heart to the lungs to pick up oxygen, the heart has to work much harder to keep up.

Among the many organs that lupus attacks are the kidneys, which normally filter blood and remove waste from the body. As many as 40 percent of all people with lupus and up to one-third of all children with lupus will develop kidney-related complications, according to the Lupus Foundation of America. As the kidneys are damaged, fluid begins to build up in the body. One of the first symptoms of lupus nephritis is edema, or swelling due to fluid buildup in the legs, ankles, and feet.