What Problems Can People With Lupus Have?
Many people with active lupus feel ill in general and complain of fever, weight loss, and fatigue. People with lupus also develop specific problems when the immune system attacks a particular organ or area in the body. The following areas of the body can be affected by lupus:
- Skin . Skin problems are a common feature of lupus. Some people with lupus have a red rash over their cheeks and the bridge of their nose — called a “butterfly” or malar rash. Hair loss and mouth sores are also common. One particular type of lupus that generally affects only the skin is called “discoid lupus.” With this type of lupus, the skin problems consist of large red, circular rashes that may scar. Skin rashes are usually aggravated by sunlight. A common lupus rash called subacute cutaneous lupus erythematosus is often worse after exposure to the sun. This type of rash can affect the arms, legs, and torso. An uncommon but serious form of lupus rash results in the development of large blisters and is called a “bullous” lupus rash.
- Joints. Arthritis is very common in people with lupus. There may be pain, with or without swelling. Stiffness and pain may be particularly evident in the morning. Arthritis may be a problem for only a few days or weeks, or may be a permanent feature of the disease. Fortunately, the arthritis usually is not crippling.
- Kidneys. Kidney involvement in people with lupus can be life threatening and may occur in up to half of those with lupus. Kidney problems are more common when someone also has other lupus symptoms, such as fatigue, arthritis, rash, fever, and weight loss. Less often, kidney disease may occur when there are no other symptoms of lupus.
- Blood. Blood involvement can occur with or without other symptoms. People with lupus may have dangerous reductions in the number of red blood cells, white blood cells, or platelets (particles that help clot the blood)
Sometimes, changes in blood counts (low red cell count, or anemia), may cause fatigue, serious infections (low white cell count), or easy bruising or bleeding (low platelet count). Many patients do not have symptoms from low blood counts, however, so it is important for people with lupus to have periodic blood tests in order to detect any problems.
Blood clots are more common in people with lupus. Clots often occur in the legs (called deep venous thrombosis or DVT) and lungs (called pulmonary embolus or PE) and occasionally in the brain (stroke). Blood clots that develop in lupus patients may be associated with the production of antiphospholipid (APL) antibodies. These antibodies are abnormal proteins that may increase the tendency of the blood to clot. Blood can be tested for these antibodies.