Lupus symptoms can vary dramatically between individuals, making diagnosis particularly difficult. This autoimmune disease can affect nearly every organ and tissue — from the skin and joints to the kidneys, heart, lungs, and brain. Recognising the diverse symptoms of lupus is essential for early detection and effective management.
General Overview of Lupus Symptoms
In many cases, lupus symptoms develop gradually but may also appear suddenly during a flare — a period of increased disease activity. These flares can be triggered by stress, sunlight, infections, or certain medications. After a flare, symptoms often subside, leading to a remission phase that may last weeks or months.
Because lupus follows a relapsing-remitting pattern, ongoing monitoring is crucial, even when symptoms temporarily improve.
Common Symptoms of Lupus
1. Fatigue
Chronic, persistent fatigue is one of the most common lupus symptoms, affecting over 80% of patients. This fatigue isn’t relieved by rest and can interfere significantly with daily life, even when other symptoms are mild.
2. Joint Pain and Swelling (Arthralgia)
Pain and stiffness in the joints, especially in the fingers, wrists, and knees, are hallmark features. Unlike rheumatoid arthritis, lupus-related joint pain usually doesn’t cause permanent deformity, but it can be severe and most noticeable in the morning or after rest.
3. Skin Rashes
- Malar rash (butterfly rash): A red or purplish rash across the cheeks and bridge of the nose, often triggered by sunlight.
- Discoid rash: Thick, scaly patches that may cause scarring.
- Photosensitivity: Increased skin sensitivity to sunlight, often leading to rashes or flares.
- Alopecia: Hair loss, especially along the hairline or scalp, is also common.
4. Fever
Low-grade fever (typically under 38.3°C or 101°F) without infection may occur during flares, often signalling increased inflammation in the body.
5. Mouth and Nose Ulcers
Painless ulcers in the mouth, nose, or on the tongue can appear during flares. While not dangerous themselves, they are often early warning signs of disease activity.
Organ-Specific Symptoms of Lupus
6. Kidney Involvement (Lupus Nephritis)
Symptoms of lupus nephritis include:
- Swelling in the legs or ankles
- Foamy or discoloured urine
- High blood pressure
- Changes in urination patterns
Kidney disease in lupus is serious and may lead to kidney failure if left untreated.
7. Neurological Symptoms
Lupus can affect the central nervous system, leading to:
- Seizures
- Severe headaches
- Memory loss or confusion
- Mood changes or psychosis
- Stroke-like episodes
These symptoms require immediate medical evaluation.
8. Cardiopulmonary Symptoms
Lupus may affect the heart and lungs:
- Pericarditis (inflammation of the heart lining): causes sharp chest pain.
- Pleuritis (inflammation of the lung lining): leads to chest pain and shortness of breath.
- Pulmonary hypertension: causes fatigue, dizziness, and breathlessness.
9. Raynaud’s Phenomenon
In response to cold or stress, the fingers and toes may turn white or blue due to poor circulation. This condition can cause pain, numbness, or tingling.
10. Gastrointestinal Symptoms
Some people with lupus experience:
- Abdominal pain
- Nausea or vomiting
- Loss of appetite
These symptoms may result from lupus itself or from side effects of medications.
11. Hematologic Symptoms
Lupus frequently affects the blood:
- Anaemia (low red blood cell count)
- Leucopenia (low white blood cells)
- Thrombocytopenia (low platelet count)
These changes may lead to increased infection risk, fatigue, or bruising.
12. Mental Health and Cognitive Symptoms
Lupus can affect the mind as well as the body, leading to:
- Depression
- Anxiety
- Memory problems
- Difficulty concentrating (sometimes referred to as “lupus fog”)
These symptoms may be caused by lupus activity, medication side effects, or the emotional impact of living with a chronic illness.
Symptoms in Children and Adolescents
Children and teens with lupus often experience:
- More severe or early kidney involvement
- Generalised inflammation
- Slowed growth or delayed puberty due to disease activity or medication effects
Not Everyone Has All Symptoms
Lupus is highly individual. Some people may only experience skin rashes, while others may suffer from severe multi-organ involvement. The combination and progression of symptoms often guide diagnosis and treatment decisions.
Summary: Recognising Lupus Symptoms
The symptoms of lupus are wide-ranging and may affect every part of a person’s physical and emotional health. Common signs include fatigue, joint pain, rashes, fever, and organ involvement. Recognising the pattern of symptoms — especially when they occur together — is essential for early diagnosis and effective treatment.
