bone, joint, and muscle disorders
Systemic Lupus Erythematosus (SLE)
Symptoms of Lupus
Symptoms of lupus vary greatly from person to person. Symptoms may begin suddenly with fever, resembling a sudden infection. Or symptoms may develop gradually over months or years with episodes (called flare-ups) of fever, feeling unwell, or any of the symptoms discussed below alternating with periods when symptoms are absent or minimal. Most people with lupus have mild symptoms affecting mostly the skin and joints. Symptoms , Joint symptoms, ranging from intermittent joint pains (arthralgias) to sudden inflammation of multiple joints (acute polyarthritis), occur in about 90% of people and may exist for years before other symptoms appear. In long-standing disease, marked joint looseness and deformity may occur (Jaccoud arthropathy or arthritis) but is rare. However, joint inflammation is generally intermittent and usually does not damage the joints. Rashes include a butterfly-shaped redness across the nose and cheeks (called a malar rash or butterfly rash), raised bumps or patches of thin skin, and flat or raised red areas on exposed areas of the face and neck, upper chest, and elbows. Blisters and skin ulcers (sores) are rare, but ulcers do commonly occur on mucous membranes, particularly on the roof of the mouth, on the inside of the cheeks, on the gums, and inside the nose. Generalized or patchy loss of hair ( Alopecia (Hair Loss) ) is common during flare-ups. Mottled red areas on the sides of the palms and up the fingers, redness and swelling around the nails, and flat, reddish purple blotches between the knuckles on the inner surfaces of the fingers also may occur. Purplish spots (purpura) may occur because of bleeding in the skin as a result of low platelet levels in the blood. Long-lasting rashes resulting from exposure to sunlight (photosensitivity) occur in some people with lupus, particularly fair-skinned people. People with lupus who have Raynaud Syndrome have very pale or bluish fingers and toes when they are exposed to cold. It is common for people with lupus to feel pain when breathing deeply. The pain is due to recurring inflammation of the sac around the lungs (pleurisy), with or without fluid (effusion—see Symptoms ) inside this sac. Inflammation of the lungs (lupus pneumonitis), resulting in breathlessness, is rare, although minor abnormalities in lung function are common. Life-threatening bleeding into the lungs may rarely occur. Blockage of arteries in the lung caused by blood clots (thrombosis) can also occur. People with lupus may have chest pain due to inflammation of the sac around the heart ( Acute Pericarditis ). More serious but rare effects on the heart are inflammation of the walls of the coronary arteries (coronary artery vasculitis), which can lead to An infant whose mother has lupus and has a certain type of antibody (anti-Rho/SSA antibody) can be born with Overview of Heart Block . Widespread enlargement of the lymph nodes is common, particularly among children, young adults, and Black people of all ages. Enlargement of the spleen ( Enlarged Spleen ) occurs in about 10% of people. Involvement of the brain (neuropsychiatric lupus) can cause Overview of Headache , mild impairment of thinking, personality changes, Kidney involvement may be minor and without symptoms or may be progressive and fatal. People may develop Overview of Kidney Failure that requires The numbers of red blood cells, white blood cells, and platelets may decrease. Platelets assist in blood clotting, so if these numbers decrease greatly, bleeding may occur. Also, and for other reasons, the blood may clot too easily, which accounts for many of the problems that can affect other organs (such as Overview of Stroke and People may have nausea, diarrhea, and vague abdominal discomfort. The occurrence of these symptoms may be the forewarning of a flare-up. Impairment of blood supply to various parts of the gastrointestinal tract may result in more severe abdominal pain, damage to the liver or pancreas ( Overview of Pancreatitis ), or a blockage or hole ( Pregnant women have a higher-than-normal risk of Miscarriage and Doctors advise women not to conceive if their lupus has not been controlled during the prior 6 months. 