Lupus vs MS: What's the Difference?

Learn What Distinguishes Lupus From Multiple Sclerosis

A visit to the doctor.
A visit to the doctor.. LWA/Getty Images

Knowing the difference between systemic lupus erythematosus and multiple sclerosis (MS) can help you and your doctor work together to make a correct diagnosis. Sometimes people with lupus are misdiagnosed with MS.

Lupus and MS Basics

Both lupus and MS are chronic autoimmune diseases. This means they are both diseases in which the immune system attacks healthy parts of the body.

In lupus, the immune system may attack various organs in the body, particularly the skin, joints, kidneys, heart, lungs or nervous system.

In multiple sclerosis, the immune system specifically attacks the myelin sheath, the fatty protective layer on nerve fibers in the brain and spinal cord.

Similarities Between the Two

Lupus and MS are very different diseases, but they have several things in common.

As with lupus, there is no definitive cause of MS and a combination of factors may play a part. There is also no definitive test for either disease. Rather, the diagnosis of lupus or MS relies on a set of characteristic symptoms, signs and lab tests that can't be explained by another diagnosis.

Both diseases most commonly affect the same population - younger women - although they affect other populations as well. And both lupus and MS can follow a pattern of remission and relapse.

While the nerves are the primary target of MS, lupus sometimes affects the nerves as well. And MRI scans may show lesions in the brain in both lupus and MS.

Differences Between Lupus and MS

MS is the most common neurological disease that strikes young people.

About half of lupus patients will have central nervous system (brain and spinal cord) symptoms.

Although both lupus and MS can affect the nervous system, the way they do so is usually different.

According to the National Multiple Sclerosis Society, the common effects of lupus on the nervous system do not typically occur in people with MS:

  • migraine headaches
  • changes in personality
  • changes in cognitive function
  • epileptic seizures
  • stroke

Why Misdiagnosis Sometimes Happens

Rarely, people with lupus will have transverse myelitis. This condition is marked by spinal cord inflammation and damage to the myelin sheath. It mimics MS and is sometimes the only lupus symptom. It can, therefore, confuse a diagnosis.

Several other commonalities between lupus and MS can contribute to a misdiagnosis:

  • Both diseases are immunological.
  • Both affect a similar population.
  • Both have a relapsing–remitting course
  • Both may have neurological symptoms.
  • Both may have brain lesions.

MS medications can make lupus symptoms appear or worsen.

For all these reasons, if you have been diagnosed with MS but your condition is "atypical," ask your doctor to consider if you might have lupus instead. Antiphospholipid antibody testing is one way that doctors can start to distinguish lupus from MS and get you on the right track toward living a healthy life.

Sources:

Ferreira, S., D’Cruz, D.P.D., and Hughes, G. R. V. (2005.) Multiple sclerosis, neuropsychiatric lupus and antiphospholipid syndrome: where do we stand? Rheumatology.

Other Conditions to Rule Out: Lupus. National Multiple Sclerosis Society.

Transverse Myelitis Fact Sheet. National Institute of Neurological Disorders and Stroke. June 24, 2015.

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