What Are the Common Signs and Symptoms of Lupus?

Joint pain and swelling

Lupus is a mysterious disease, one with a multitude of smaller signs and symptoms that are often overlooked or misinterpreted as a harbinger of a different disease, leading to misdiagnosis. But when one of the most common symptoms is accompanied by a more suggestive sign or complication, lupus starts to become clear.

These symptoms are often what patients notice themselves; there are other symptoms a doctor may discover upon closer examination and blood tests.

Your doctor may order an anti-nuclear antibody (ANA) blood test. The ANA test immune system identifies autoantibodies that attack the body's own tissue and cells. These autoantibodies are unlike normal antibodies that target bacteria, viruses, parasites, and fungi. A positive ANA test by itself does not mean a person has lupus, but in combination with symptoms, physical examination, and other laboratory tests, a positive test result may help diagnose lupus.

Other autoimmune diseases such as Sjogren's syndrome, rheumatoid arthritis, and scleroderma can also show a positive ANA. For this reason, your doctor may order some other blood tests to correctly diagnose lupus. Three of the other tests are called an anti-DNA, anti-RNA, and an anti-Sm.

Abnormal blood clotting, Reynaud's disease (characterized by circulation problems), and seizures may also be symptoms your doctor will look for.

Some of the most common symptoms include:

  • achy joints with swelling
  • extreme fatigue
  • unexplained rashes
  • unexplained rashes that turn to sores, then scar
  • butterfly (malar) rash across nose and cheeks
  • anemia
  • pleurisy (pain in the chest when deep breathing)
  • ulcers inside the mouth and nose
  • photosensitivity
  • cardiopulmonary disorders (heart/lung)

Usually, it isn't until those symptoms are coupled with other, more suggestive signs that doctors tend to consider lupus as a possible diagnosis.

Dermatological Symptoms

Lupus patients may notice various lesions or rashes developing on their skin. These abnormal skin areas are referred to as skin or cutaneous disease. Chronic cutaneous (discoid lupus), subacute cutaneous (scaly patches with distinct borders occurring on sun-exposed areas, but less on the face), and acute cutaneous (flattened areas of red, like a sunburn, on the face) are the three types of skin disease that occur only in people with lupus.

However, there are other skin diseases that can occur in lupus and in other autoimmune diseases. Those include vasculitis (inflammation of the lining of the blood vessels appearing as red bumps or spots on the lower legs), hair loss, calcinosis (calcium deposits on the skin), and livedo reticularis (a red, network-like pattern in the skin caused by plugged blood vessels).

Mucosal ulcers in the nose or mouths are another common complaint of those with lupus. Like other symptoms, the ulcers can come and go as the disease flares.

Renal Symptoms

Inflammation of the kidneys in lupus patients is called lupus nephritis. Some patients have no indication of kidney problems, but some symptoms are weight gain, high blood pressure, swelling in the face, legs, and/or fingers.

Lupus nephritis can lead to kidney failure in some patients and is a serious, often silent problem affecting lupus patients.

Cardiopulmonary Symptoms

There are several inflammatory heart and lung issues that can affect lupus patients. By far the most common are inflammation to the lining of the heart (pericarditis) and inflammation of the sac around the lung (pleurisy). Less common are inflammation of heart tissue (myocarditis), inflammation of the blood vessels in the heart (coronary vasculitis), or inflammation of the lung itself (pneumonitis).

Musculoskeletal Symptoms

Joint pain and swelling is a primary symptom of lupus, usually occurring in connective joints such as elbows, wrists, knees and ankles.

Lupus joint pain also tends to occur on both sides of the body at once, for example in both knees, or both ankles. Unlike rheumatoid arthritis, lupus joint pain is less disabling and usually not deforming to the hands and feet.

Hematological Symptoms

Two blood disorders found in lupus patients are anemia (low red blood cell count), which can be caused by inflammation, kidney disorders, or as a side effect of lupus medications, and Thrombosis (excess clotting), which can lead to clots traveling to the lungs, heart, or brain.

“Symptoms" The Lupus Foundation of America. Collected June 2007.
“Lupus: Signs and Symptoms" The Mayo Clinic. Mayo Clinic Staff. 27 December 2006.