Lupus (Systemic Lupus Erythematosus)

What is lupus?

Lupus is a condition that causes inflammation throughout your body. It’s an autoimmune disease, which means your immune system damages your body instead of protecting it. You may experience symptoms throughout your body depending on where your autoimmune system damages tissue, including in your:

• Skin.
• Blood.
• Joints.
• Kidneys.
• Brain.
• Heart.
• Lungs.

Visit a healthcare provider if you notice new pain, rashes or changes to your skin, hair or eyes.

Types of lupus

Healthcare providers sometimes call lupus systemic lupus erythematosus (SLE). It’s the most common type of lupus, and means you have lupus throughout your body. Other types include:

• Cutaneous lupus erythematous: Lupus that only affects your skin.
• Drug-induced lupus: Some medications trigger lupus symptoms as a side effect. It’s usually temporary and might go away after you stop taking the medication that caused it.
• Neonatal lupus: Babies are sometimes born with lupus. Babies born to biological parents with lupus aren’t certain to have lupus, but they might have an increased risk.

What are lupus symptoms?

Lupus causes symptoms throughout your body, depending on which organs or systems it affects. Everyone experiences a different combination and severity of symptoms.

Lupus symptoms usually come and go in waves called flare-ups. During a flare-up, the symptoms can be severe enough to affect your daily routine. You might also have periods of remission when you have mild or no symptoms.

Symptoms usually develop slowly. You might notice one or two signs of lupus at first, and then more or different symptoms later on. The most common symptoms include:

• Joint pain, muscle pain or chest pain (especially when you’re taking a deep breath).
• Headaches.
• Rashes (it’s common to have a rash across your face that providers sometimes call a butterfly rash).
• Fever.
• Hair loss.
• Mouth sores.
• Fatigue (feeling tired all the time).
• Shortness of breath (dyspnea).
• Swollen glands.
• Swelling in your arms, legs or on your face.
• Confusion.
• Blood clots.

Lupus can sometimes cause other health conditions or issues, including:

• Photosensitivity (sensitivity to sunlight).
• Dry eye.
• Depression (or other mental health conditions).
• Seizures.
• Anemia.
• Raynaud’s syndrome.
• Osteoporosis.
• Heart disease.
• Kidney disease.

What causes lupus?

Experts don’t know for certain what causes lupus. Studies have found that certain factors about your health or where you live may trigger lupus:

• Genetic factors: Having certain genetic mutations may make you more likely to have lupus.
• Hormones: Reactions to certain hormones in your body (especially estrogen) may make you more likely to develop lupus.
• Environmental factors: Aspects about where you live and how much pollution or sunlight you’re exposed to might affect your lupus risk.
• Your health history: Smoking, your stress level and having certain other health conditions (like other autoimmune diseases) might trigger lupus.

Risk factors

Anyone can develop lupus, but some groups of people have a higher risk:

• People assigned female at birth (AFAB), especially people AFAB between the ages of 15 and 44.
• Black people.
• Hispanic people.
• Asian people.
• Native Americans, Alaska Natives and First Nations people.
• Pacific Islanders.
• People with a biological parent who has lupus.

How is lupus diagnosed?

A healthcare provider will diagnose lupus with a physical exam and some tests. They’ll examine your symptoms and talk to you about what you’re experiencing. Tell your provider when you first noticed symptoms or changes in your body. Your provider will ask about your medical history, including conditions you may have now and how you’re treating or managing them.

Lupus can be tricky to diagnose because it can affect so many parts of your body and cause lots of different symptoms. Even small changes or issues that seem unusual for you can be a key. Don’t be afraid to tell your provider about anything you’ve felt or sensed — you know your body better than anyone.

Which tests do providers use to diagnose lupus?

There’s not one test that can confirm a lupus diagnosis. Diagnosing it is usually part of a differential diagnosis. This means your provider will probably use a few tests to determine what’s causing your symptoms before ruling out other conditions and diagnosing you with lupus. They might use:

• Blood tests to see how well your immune system is working and to check for infections or other issues like anemia or low blood cell counts.
• Urinalysis to check your pee for signs of infections or other health conditions.
• An antinuclear antibody (ANA) test looks for antibodies (protein markers that show a history of your body fighting off infections). People who have lupus usually have certain antibodies that show their immune system has been overly active.
• A biopsy of your skin or kidney tissue can show if your immune system has damaged them.

What is lupus treatment?

Your healthcare provider will suggest treatments for lupus that manage your symptoms. The goal is minimizing damage to your organs and how much lupus affects your day-to-day life. Most people with lupus need a combination of medications to help them prevent flare-ups and lessen their symptom severity during one. You might need:

• Hydroxychloroquine: Hydroxychloroquine is a disease-modifying antirheumatic drug (DMARD) that can relieve lupus symptoms and slow down how they progress (change or get worse).
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) NSAIDs relieve pain and reduce inflammation. Your provider will tell you which type of NSAID will work best for you, and how often you should take it. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
• Corticosteroids: Corticosteroids are prescription medications that reduce inflammation. Prednisone is a common corticosteroid providers use to manage lupus. Your provider might prescribe you pills you take by mouth or inject a corticosteroid directly into one of your joints.
• Immunosuppressants: Immunosuppressants are medications that hold back your immune system and stop it from being as active. They can help prevent tissue damage and inflammation.

You might need other medications or treatments to manage specific lupus symptoms you have or other health conditions it’s causing. For example, you may need treatment for anemia, high blood pressure (hypertension) or osteoporosis if lupus causes those issues.

Can I prevent lupus?

You can’t prevent lupus because experts aren’t sure what causes it. Talk to a healthcare provider about your risk if one of your biological parents has lupus.

How can I prevent lupus flare-ups?

You might be able to prevent and reduce lupus flare-ups by avoiding activities that trigger your symptoms, including:

• Avoiding sun exposure: Spending too much time in the sun can trigger lupus symptoms in some people. Try to avoid going outside when the sun is brightest (usually between 10 a.m. and 4 p.m.). Wear long sleeves, a hat or sun-protective clothing. Use a sunscreen that’s at least SPF 50.
• Staying active: Joint pain can make it hard or painful to move. But moving and gently using your joints can be the best way to relieve symptoms like pain and stiffness. Walking, biking, swimming, yoga and tai chi are all great ways to move your body without putting too much stress on your joints. Ask your healthcare provider which types of activities are safest for you.
• Getting enough sleep and protecting your mental health: Living with lupus can be frustrating. Getting the right amount of sleep (seven to nine hours for adults) and reducing your stress can help prevent flare-ups for some people. A psychologist or other mental health professional can help you develop healthy coping mechanisms.

What can I expect if I have lupus?

Lupus is a lifelong (chronic) condition. You should expect to manage lupus symptoms for the rest of your life.

Lupus can be unpredictable, and the way it impacts you can change over time. You’ll need to regularly visit your healthcare provider so they can track changes in your symptoms.

You’ll probably work with a team of providers as you learn to live with lupus. Your primary care provider will suggest specialists who can help with specific issues or symptoms. You’ll probably need to visit a rheumatologist — a healthcare provider who specializes in diagnosing and treating autoimmune diseases. Which specialists you need to visit depends on which symptoms you have and how they affect your body.

Is there a cure for lupus?

There’s currently no cure for lupus. Your healthcare provider will help you find a combination of treatments to manage your symptoms and hopefully put lupus into remission (long periods of time with no symptoms or flare-ups).

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice any new or changing symptoms. Even small shifts in what you’re feeling and experiencing can be important.

Talk to your provider if it feels like your treatments aren’t managing lupus symptoms as well as they used to. Tell your provider if you’re having flare-ups more often — or if the flare-ups cause more severe symptoms. They’ll help you adjust your treatments as needed.

Go to the emergency room or call 911 (or your local emergency services number) if you’re experiencing any of the following symptoms:

• You can’t breathe.
• You’re in severe pain.
• You think you’re experiencing heart attack symptoms.

What questions should I ask my healthcare provider?

• Do I have lupus or another autoimmune disease?
• Which medications will I need?
• How often should I see you for follow-up appointments?
• Will I need to visit other specialists?
• Can you suggest any support groups or other mental health resources?

A note from Cleveland Clinic

Lupus can be a frustrating, tiring condition. Pain, inflammation and irritation throughout your body can be exhausting. But don’t forget to appreciate yourself. Living with a chronic condition is hard work, and you deserve credit for managing your symptoms every day. Ask your provider about mental health resources and support groups if you think talking to someone about how you’re feeling could help you.

Don’t be afraid to talk to your provider and ask questions. Even small changes in your symptoms or health can be a sign that lupus is affecting you differently. Remember, you’re the best judge of when something isn’t quite right in your body.