Lupus
Also known as: SLE, systemic lupus erythematosus, systemic lupus, Lupus (systemic lupus erythematosus)
A long-term autoimmune condition in which the immune system attacks healthy tissue, most often causing joint aches, skin rashes and tiredness.
When to seek care
A routine GP appointment is the usual route if lupus symptoms keep coming back, since the NHS says symptoms can improve if treatment starts early. Severe or sudden symptoms, such as chest pain, need urgent help: NHS 111 or the GP the same day, and call 999 in an emergency.
Overview
Lupus is a lasting autoimmune illness in which the immune system attacks healthy tissue. It is most often marked by joint aches, skin rashes and fatigue, and symptoms vary from person to person and can come and go. It is more common in women. There is no cure, but symptoms can improve if treatment starts early.
Causes
- Autoimmune: the immune system attacks healthy tissue
- The exact trigger is unclear
- Possible contributors named by the NHS include viral infections, certain medicines, sunlight, puberty, childbirth and the menopause
Risk factors
- Being a woman
- Being of African, Caribbean, Asian or Chinese background
Symptoms
What a clinician may find
- A rash across the nose and cheeks, sometimes called a butterfly rash
- Painful, swollen joints with morning stiffness
- Mouth ulcers and hair loss
- A high level of a certain type of antibody on blood tests
Complications
- In severe cases, serious inflammation of the heart, lungs, brain or kidneys
- Lupus nephritis (kidney inflammation), which in a few cases can progress to kidney failure
- Pregnancies can sometimes end in miscarriage or stillbirth
- Pre-eclampsia, a pregnancy complication that Lupus UK discusses for women with lupus
Diagnosis
No single test confirms lupus, so doctors combine the person's history, a physical examination and laboratory tests. A GP usually starts with blood tests, and lupus may be diagnosed if they show a high level of a certain type of antibody together with typical symptoms. Urine and blood tests, and sometimes a kidney biopsy, may be used when the kidneys might be affected. Scans of the heart, kidneys or other organs may follow if they seem affected.
Treatment
There is no cure. Lupus UK says treatment aims to keep the disease controlled to reduce the chance of a flare. The NHS lists anti-inflammatory painkillers such as ibuprofen, hydroxychloroquine for fatigue, skin and joint problems, and steroids for kidney inflammation and rashes. Immunosuppressant or biological medicines may be used for severe cases. Self-care includes sun protection, pacing yourself, staying active and managing stress.
Prevention
The NHS describes self-care that includes sun protection, pacing and managing stress. The sources reviewed did not describe a way to prevent lupus itself.
Key facts
| Fact | Detail |
|---|---|
| Also called | Systemic lupus erythematosus, SLE |
| Type of condition | A lasting autoimmune illness |
| Main features | Joint and muscle pain, extreme tiredness and a rash across the nose and cheeks |
| Usually diagnosed by | A combination of history, examination and blood tests; no single test confirms it |
| More common in | Women, and people of African, Caribbean, Asian or Chinese background |
| Contagious? | No |
| Cure? | None, but symptoms can improve if treatment starts early |
What are the symptoms of lupus?
Lupus symptoms vary from person to person. The NHS lists joint and muscle pain and extreme tiredness that does not go away however much a person rests as main symptoms. A rash often appears across the nose and cheeks and can be triggered by sunlight. NIAMS describes this as a butterfly-shaped rash.
Other possible signs include headaches, mouth ulcers, fever, hair loss, weight loss and swollen glands. Some people have Raynaud's, where the fingers and toes change colour. Arthritis in lupus can cause painful, swollen joints and morning stiffness. The NHS says lupus often flares up, with symptoms becoming worse for a few weeks or sometimes longer. Lupus can also affect organs such as the kidneys, heart, lungs and brain.
What causes lupus and who gets it?
Lupus is an autoimmune condition, which means the immune system attacks healthy tissue. Lupus UK explains that the immune system becomes overactive and makes antibodies against the body's own cells, and inflammation can then affect the skin, joints and other tissues. The NHS says lupus is not contagious.
The causes are not fully understood, but the NHS lists possible triggers including viral infections, certain medicines, sunlight, puberty, childbirth and the menopause. The NHS says lupus is more common in women and in people of African, Caribbean, Asian or Chinese background. Lupus UK describes the course as variable, with flares and remission, and says the disease lasts many years in most people.
How is lupus diagnosed?
Because the symptoms overlap with other conditions, diagnosis can take time. No single test confirms lupus, and doctors combine the person's history, a physical examination and laboratory tests.
A GP usually starts with blood tests. NIAMS says a positive ANA (antinuclear antibody) test is common in lupus but does not confirm it, because healthy people can also have a positive result. The NHS says lupus may be diagnosed if tests show a high level of a certain type of antibody and the person also has the typical symptoms. NIDDK says lupus nephritis, which is kidney involvement, is diagnosed through urine and blood tests and sometimes a kidney biopsy. Scans of the heart, kidneys or other organs may follow if they seem to be affected.
How is lupus treated?
There is no cure for lupus, but the NHS says symptoms can improve if treatment starts early. Lupus UK says treatment aims to keep the disease controlled to reduce the chance of a flare.
Options named by the NHS include anti-inflammatory painkillers such as ibuprofen, hydroxychloroquine for fatigue, skin and joint problems, and steroids for kidney inflammation and rashes. For severe cases, immunosuppressant or biological medicines may be used. NIAMS mentions a biologic medicine that blocks the type I interferon receptor and may improve skin, joint and overall lupus symptoms. NIAMS advises working with a doctor to decide the best treatment plan and taking medicines as prescribed. The NHS self-care advice for people with lupus includes sun protection, pacing yourself, staying active and managing stress.
Living with lupus: flares and self-care
Lupus UK describes the course as variable. Some people have one flare, while others have periods of increased disease activity followed by remission, and many flares are mild. NIAMS lists increased tiredness, joint swelling, pain, rash, fever, abdominal pain and headache as common warning signs of a flare. It says spotting these warning signs can help a person prevent a flare or make the symptoms less severe, and that sun exposure and stress can trigger flares.
The NHS self-care advice includes sun protection, pacing yourself, staying active and managing stress. Sun protection includes a high-factor sunscreen and a hat. NHS 111 Wales also advises against smoking, which it says makes lupus worse. NIAMS says many people with lupus lead happy lives.
What complications can lupus cause?
Severity varies, and a severe case can cause serious inflammation of the heart, lungs, brain or kidneys. Lupus nephritis is inflammation of the kidneys, and Great Ormond Street Hospital says it can in a few cases progress to kidney failure. Lupus UK says kidney disease in lupus needs careful monitoring because it can cause no symptoms, and NIDDK says it is found through urine and blood tests and sometimes a biopsy.
Lupus UK says many women with lupus have successful pregnancies, and that stable disease before conception makes a stable pregnancy more likely. It also says lupus pregnancies can sometimes end in miscarriage or stillbirth, that some women have flares during pregnancy and need careful observation, and that lupus may sometimes affect fertility. Lupus UK also discusses pre-eclampsia, a pregnancy complication, and advises that individual pregnancy questions are discussed with a specialist.
Frequently asked questions
Is lupus contagious?
No, lupus is not contagious. It is an autoimmune condition, in which the immune system attacks healthy tissue. The exact trigger is unclear, but the NHS lists possible contributors including viral infections, certain medicines, sunlight, puberty, childbirth and the menopause. These are possible contributors to developing lupus, not ways of catching it from another person.
Can lupus be cured?
There is no cure for lupus, according to the NHS. The NHS says symptoms can improve if treatment starts early. Lupus UK says treatment aims to keep the disease controlled to reduce the chance of a flare. The NHS lists anti-inflammatory painkillers, hydroxychloroquine and steroids, with immunosuppressant or biological medicines for severe cases.
What is the outlook for people with lupus?
Lupus UK says the outlook for survival has improved in recent years, and that with early treatment lupus may settle and ultimately go into remission. The course is variable: some people have one flare, while others have periodic increased disease activity followed by remission. A rheumatologist or lupus specialist can discuss what this means for an individual.
Can women with lupus have a baby?
Lupus UK says many women with lupus have successful pregnancies, and that stable disease before conception makes a stable pregnancy more likely. It also says lupus pregnancies can sometimes end in miscarriage or stillbirth, and that some women have flares during pregnancy and need careful observation. Questions about pregnancy are best discussed with a rheumatologist or lupus specialist.
When should I see a doctor about possible lupus?
The NHS advises seeing a GP if lupus symptoms occur often, and says symptoms can improve if treatment starts early. Joint and muscle pain, extreme tiredness that rest does not ease, and a rash across the nose and cheeks are among the main symptoms. A routine GP appointment is the usual first step. Severe or sudden symptoms, such as chest pain, need urgent help through NHS 111 or the GP the same day, or 999 in an emergency.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Lupus.
Conditions
- Rheumatoid arthritis A chronic autoimmune disease in which the immune system attacks the synovial lining of joints.
- Chronic kidney disease Persistent reduction in kidney function (a filtration rate below 60 ml/min) or evidence of kidney damage such as protein in the urine.
Symptoms
- Fatigue Persistent tiredness that rest does not fix.
- Joint pain Pain in one or more joints.
- Rash Any change in the colour or texture of the skin.
- Fever A body temperature of 38 °C (100.4 °F) or more, produced when the hypothalamus raises its set point in response to inflammatory signals.
Medical tests
- Full blood count The most commonly ordered blood test: an automated count of the red cells, white cells and platelets in a small sample.
- Kidney function tests Creatinine and urea are waste products the kidneys should clear; how much builds up in blood shows how well they are filtering.
- Urine protein Healthy kidney filters hold back almost all protein.
- Biopsy Removal of a small piece of tissue or a few cells so a pathologist can examine them under the microscope.
Medications
- Ibuprofen A non-steroidal anti-inflammatory (NSAID) that eases pain, inflammation and fever by blocking prostaglandin production.