Lupus is a long-term autoimmune disease in which the immune system mistakenly attacks the body’s own tissues. It can affect the skin, joints, kidneys, blood cells, heart, lungs and brain.
The condition often follows a pattern of flares, when symptoms become more active, and remission, when symptoms improve. There is currently no cure, but with early diagnosis, appropriate treatment and regular follow-up, most people with lupus can lead full and active lives.
The most common and serious form is systemic lupus erythematosus (SLE). Other forms include cutaneous lupus, which mainly affects the skin; drug-induced lupus, which usually improves after the responsible medicine is stopped; and the rare neonatal lupus, which occurs in newborns.
Causes and Risk Factors
The exact cause of lupus is unknown. It is thought to develop through a combination of genetic, hormonal and environmental factors.
Lupus is not contagious.
Factors associated with lupus include:
About 9 in 10 patients are women, with diagnosis commonly occurring between the ages of 15 and 45.
Lupus is more common and may be more severe in people of Asian, African and Hispanic descent.
Having a family history of lupus or another autoimmune disease may increase risk.
Possible triggers include sunlight, infections, smoking and certain medicines.
Symptoms of Lupus
Lupus can affect many parts of the body, so symptoms vary considerably between individuals and can resemble those of other conditions.
Common symptoms include:
Extreme fatigue
Fever
Unexplained weight loss
A butterfly-shaped rash across the cheeks and nose
Sensitivity to sunlight
Joint pain and swelling, particularly in the hands and wrists
Mouth ulcers
Hair loss
Chest pain when taking a deep breath, caused by inflammation around the heart or lungs
Fingers turning white or blue in cold temperatures, known as Raynaud’s phenomenon
Kidney and Other Organ Involvement
Kidney involvement, known as lupus nephritis, affects up to half of patients and may initially cause no obvious symptoms.
For this reason, regular blood and urine tests are important even when a person feels well.
Lupus can also cause:
Anaemia
Low platelet levels
Blood clots
Memory problems
Mood changes
Seizures
How Lupus Is Diagnosed
There is no single test that confirms lupus.
A rheumatologist usually makes the diagnosis by combining a person’s symptoms, physical examination and laboratory findings.
Tests may include:
Antinuclear antibody (ANA): Positive in nearly all people with lupus.
Anti-dsDNA antibodies: More specific for lupus and may provide information about disease activity.
Anti-Smith antibodies: Another antibody more specifically associated with lupus.
Complement levels (C3 and C4): Low levels may indicate active disease.
Complete blood count: Helps identify abnormalities such as anaemia or low platelet counts.
Urine tests: Used to look for possible kidney involvement.
If lupus nephritis is suspected, a kidney biopsy may sometimes be required.
Treatment
Treatment aims to control symptoms, reduce flares and protect organs from long-term damage.
The medicines used depend on the severity of the disease and which organs are affected.
Hydroxychloroquine
Hydroxychloroquine is a mainstay of treatment for most people with lupus. People taking it require regular eye examinations, generally once a year.
NSAIDs
Non-steroidal anti-inflammatory drugs may provide short-term relief from joint pain and fever.
Corticosteroids
Steroids can rapidly control inflammation during lupus flares. Doctors generally aim to reduce them to the lowest effective dose once symptoms improve.
Immunosuppressants
Medicines such as:
Azathioprine
Mycophenolate
Cyclophosphamide
may be used when lupus causes significant organ involvement.
Biologic Medicines
Treatments such as belimumab and anifrolumab may be considered when the disease is not adequately controlled with standard therapy.
Regular medical follow-up remains important even during periods when symptoms are well controlled.
Living With Lupus
Daily habits can play an important role in reducing triggers and maintaining overall health.
People with lupus are generally advised to:
Use sunscreen regularly
Take prescribed medicines consistently
Avoid smoking
Exercise gently and regularly
Get adequate sleep and rest
Attend scheduled medical follow-ups
Most women with lupus can have healthy pregnancies, but pregnancy should ideally be planned with the treating doctor after the disease has remained inactive for at least six months.
With modern treatment, most people with lupus now have a near-normal life expectancy.
When to See a Doctor
Consider medical evaluation for symptoms such as:
An unexplained facial rash
Persistent joint pain or swelling
Ongoing fever or severe fatigue
Recurrent mouth ulcers
People already diagnosed with lupus should seek urgent medical attention for:
Chest pain
Breathlessness
Leg swelling
Foamy urine
High fever
Seizures
Confusion
The Bottom Line
Lupus is a complex autoimmune disease that can affect several organs and varies greatly from one person to another. Although there is no cure, early diagnosis, regular monitoring and appropriate treatment can control disease activity, prevent complications and protect long-term health.
Medical disclaimer: This article is intended for general educational information and does not replace diagnosis, treatment or advice from a qualified healthcare professional.
