From the Guidelines
Lupus presents with a variety of signs and symptoms that can affect multiple body systems, including extreme fatigue, joint pain and swelling, a butterfly-shaped rash, skin lesions, fever, headaches, and sensitivity to sunlight, as noted in the 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus 1.
Common Symptoms
- Extreme fatigue
- Joint pain and swelling
- Butterfly-shaped rash across the cheeks and nose
- Skin lesions that worsen with sun exposure
- Fever
- Headaches
- Sensitivity to sunlight
- Raynaud's phenomenon (fingers turning white or blue in cold temperatures)
- Chest pain
- Shortness of breath
- Dry eyes
- Hair loss
Internal Organ Involvement
- Kidney inflammation
- Memory problems
- Blood disorders like anemia or increased risk of blood clots
Disease Variability
Lupus symptoms often fluctuate, with periods of flares when symptoms worsen and remissions when symptoms improve or disappear, as mentioned in the EULAR recommendations 1. The disease varies greatly between individuals, with some experiencing mild symptoms while others develop severe complications affecting vital organs.
Diagnosis and Treatment
Diagnosis typically requires multiple symptoms, as no single sign is definitive for lupus, and treatment goals include long-term patient survival, prevention of organ damage, and optimization of health-related quality of life, as stated in the 2019 update of the EULAR recommendations 1. If you experience several of these symptoms, especially the characteristic butterfly rash or unexplained joint pain with fatigue, consult a healthcare provider for proper evaluation. The EULAR recommendations also emphasize the importance of a multidisciplinary approach to SLE care, considering individual, medical, and societal costs 1.
From the Research
Signs and Symptoms of Lupus
The signs and symptoms of lupus can vary widely, but some common manifestations include:
- Neuropsychiatric symptoms, such as psychosis, cognitive dysfunction, peripheral neuropathy, stroke, headache, and seizures 2, 3, 4, 5
- Inflammatory neurologic and psychiatric manifestations, which can be heterogeneous and have variable clinical presentation 5
- Psychosis, which can be a rare manifestation of neuropsychiatric systemic lupus erythematosus (NPSLE) 3, 4, 6
- Mood disorders, such as depression and anxiety 2
- Cognitive impairment 2
Neuropsychiatric Manifestations
Neuropsychiatric manifestations of lupus, including psychosis, can be caused by various factors, such as:
- Inflammatory cytokines 2
- Autoantibodies 2, 3
- Immune complexes 2
- Vasculopathic, cytotoxic, and autoantibody-mediated neuronal injury 2
Treatment and Management
Treatment and management of lupus and its manifestations can include:
- Corticosteroids, which are accepted as first-line treatment in NPSLE 5
- Cyclophosphamide, which has moderate evidence supporting its benefit in treating NPSLE 5
- Synthetic DMARDs, such as mycophenolate, azathioprine, and intrathecal methotrexate, which have limited data supporting their use 5
- Biologic therapies, such as rituximab, which has low-moderate evidence supporting its benefit in refractory disease 5
- Therapeutic plasma exchange, intravenous immunoglobulin, and hydroxychloroquine, which have limited evidence supporting their use as adjuvant treatments 5