Lupus: Early Signs and Symptoms

Systemic lupus erythematosus--better known as lupus or SLE--is an autoimmune disease affecting the skin, kidneys, lungs, joints and other body organs. The immune system protects the body from infectious agents. To do this, it has a system for recognizing your cells versus foreign material. With autoimmune disease, this recognition mechanism is askew and the immune system mistakenly attacks body tissues. Lupus is a health-related case of mistaken identity. With so many organs potentially involved, lupus signs and symptoms are highly variable 1. Some common early signs and symptoms can help point toward a diagnosis of lupus 1.

Fatigue

Fatigue is an almost universal symptom of lupus. In some people, this symptom becomes so severe that everyday functioning is a struggle. No amount of sleep alleviates this persistent fatigue. In a 2010 article published in “Arthritis Care and Research,” Dr. D. Robinson Jr. and colleagues found that 87 percent of people with lupus reported fatigue as a frequent health issue.

Low-Grade Fever

Low-grade fevers are common in people with lupus. Some people may not be aware of the fevers as they come and go. The increased activity of the immune system in SLE underlies the presence of fever.

Joint Pain

The immune system often attacks the joints in people with lupus. This causes pain and possibly swelling. Stiffness of the affected joints is common. Often, several joints are affected simultaneously.

Facial Rash

Malar rash is a classic symptom of lupus 1. Redness is present across the bridge of the nose and the upper areas of the cheeks--those parts of the face that are most exposed when in the sun. The malar rash of lupus is often described as a butterfly rash because the outline resembles the shape of a butterfly. In a 2010 article published in the “Indian Journal of Dermatology,” Drs. A. Kole and A. Ghosh reported that 80 percent of study participants seen in a rheumatology clinic for lupus exhibited a malar rash 1.

Body Rashes

People with lupus often have increased sensitivity to sun exposure. Rashes on sun-exposed surfaces such as the chest, shoulders, upper arms and hands may develop. Often the rash first appears or gets worse after being in the sun.

Raynaud's Phenomenon

People with lupus may exhibit Raynaud’s phenomenon--periodic spasms of the blood vessels of the fingers or toes. During a spasm, the blood vessels constrict, severely limiting blood supply to the affected fingers or toes. The affected area typically turns white and often goes numb. When blood supply returns, the area turns bright red. Cold temperature and stress often trigger an attack of Raynaud’s phenomenon.

Hair Loss

Lupus may affect the skin of the scalp, causing hair loss. The hair loss from lupus is usually permanent.

Nose or Mouth Ulcers

Slow-healing ulcers in the nose or mouth are a possible early sign of lupus. The underlying cause is a local attack by the immune system.

Unintentional Weight Loss

Unintentional weight loss may be an early symptom of lupus. Although this symptom is not specific to lupus, if it is present with other characteristic symptoms, suspicion for SLE increases 1.