12 Lupus Symptoms That Can Be Easy to Miss

By Midrand Medical Centre


12 Lupus Symptoms That Can Be Easy to Miss


Lupus can be difficult to recognise because it does not look the same in every person. Symptoms may appear gradually, come and go in flares or resemble several other medical conditions. Understanding the possible patterns can help someone seek appropriate care without assuming that one rash, painful joint or abnormal blood test automatically means lupus.

What Is Lupus?

Systemic lupus erythematosus, usually shortened to SLE or lupus, is a long-term autoimmune condition. The immune system mistakenly attacks healthy tissue, causing inflammation that may affect the skin, joints, kidneys, blood cells, heart, lungs or nervous system.

Lupus is not contagious, and it is not caused by something the person did wrong. It affects women more often than men and may be more common or severe among people with African, Asian and certain other ancestries, but anyone can develop it.

Symptoms Can Come and Go

Periods of increased disease activity are called flares, while quieter periods may be described as remission or low disease activity. A person’s early warning signs may include increasing tiredness, joint discomfort, a recurring rash or fever.

The following symptoms can occur with lupus, but they are not unique to the condition. Diagnosis depends on the overall pattern and appropriate medical investigations.

Possible Lupus Symptoms

Fatigue and Unexplained Fever

Fatigue is one of the most commonly reported symptoms and may feel more intense than ordinary tiredness after a busy day. It can interfere with work, concentration, exercise and social activities even after a full night’s sleep.

A recurring low-grade fever or a general feeling of being unwell may accompany a flare. However, fever can also indicate infection - particularly in someone taking immune-suppressing medication - so it should not automatically be blamed on lupus.

Joint and Muscle Symptoms

Pain, stiffness and swelling often affect the hands, wrists, knees or ankles and may be worse in the morning or after rest. Symptoms may move between joints and can occur without the same pattern of joint damage seen in some other inflammatory arthritic conditions.

Muscle aches or weakness can also occur. Because thyroid conditions, viral illnesses, rheumatoid arthritis and other problems can cause similar symptoms, an examination is important.

Rashes, Sun Sensitivity and Hair Changes

The best-known lupus rash spreads across the cheeks and bridge of the nose in a butterfly-like shape, but many people with lupus never develop it. Other rashes may appear on sun-exposed areas such as the face, neck, upper chest or arms.

Sunlight can trigger skin symptoms and, in some people, a wider flare. Recurrent mouth or nose ulcers, patchy hair loss or general hair thinning can also occur.

Colour Changes in the Fingers and Toes

Raynaud’s phenomenon causes the fingers or toes to turn unusually pale, blue or red in response to cold temperatures or emotional stress. They may feel numb, painful or tingly as blood flow changes.

Raynaud’s can occur without lupus and is also associated with other autoimmune conditions. New, severe or one-sided colour changes should be assessed, especially if sores develop.

Swelling or Changes in Urine

Lupus can inflame the kidneys, sometimes without causing obvious discomfort. Possible clues include puffiness around the eyes, swelling in the feet or lower legs, foamy urine, blood in the urine or high blood pressure.

Urine and blood tests can detect kidney involvement before a person feels unwell. Early treatment is important because untreated lupus nephritis can cause lasting kidney damage.

Chest Pain or Breathing Symptoms

Inflammation may affect the lining around the lungs, causing sharp chest pain that becomes worse when breathing deeply or coughing. Lupus can also inflame the lining around the heart and increase the long-term risk of cardiovascular disease.

Chest pain and shortness of breath have many possible causes, including medical emergencies. They require prompt assessment rather than self-diagnosis.

Blood and Nervous-System Symptoms

Lupus may affect red blood cells, white blood cells or platelets, contributing to anaemia, frequent infections, easy bruising, nosebleeds or tiny red-purple spots under the skin. Certain lupus-related antibodies can also increase the risk of blood clots.

Headaches, difficulty concentrating, memory problems, mood changes, numbness or tingling may occur, although these symptoms have many other causes. Seizures, sudden weakness, facial drooping or difficulty speaking need emergency care.

How Is Lupus Diagnosed?

There is no single test that can diagnose lupus. A doctor considers the history of symptoms, physical findings and a combination of blood and urine tests, sometimes supported by imaging or a tissue biopsy.

Most people with lupus have a positive antinuclear antibody, or ANA, test, but many healthy people also test positive. An ANA result on its own is therefore not a lupus diagnosis and should be interpreted alongside more specific antibodies, blood counts, kidney tests, urine findings and clinical symptoms.

How Is Lupus Treated?

Treatment is tailored to the organs involved and the severity of the disease. Hydroxychloroquine is commonly recommended for suitable people with SLE, while anti-inflammatory medicines, corticosteroids, immune-suppressing medicines or targeted biological treatments may be used in different circumstances.

Current care aims to control disease activity while limiting prolonged exposure to high-dose corticosteroids. Regular monitoring remains important even when symptoms are quiet.

Living Well With Lupus

Sun protection, not smoking, appropriate activity, sufficient rest and keeping vaccinations and routine health checks up to date all support long-term health. Medication should not be stopped or changed during a flare without medical advice.

Anyone planning a pregnancy should speak to their healthcare team beforehand, as the disease and certain medicines may affect pregnancy. With suitable treatment and monitoring, many people with lupus lead active, fulfilling lives.

Lupus symptoms can be confusing, but you do not have to work them out alone.

Please call Midrand Medical Centre on 011 315 2512 to arrange an appointment with one of our GPs, who can begin the assessment and arrange specialist referral when appropriate.

Sources

Location: Midrand, South Africa

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