Lupus is an autoimmune disease. In other words, it causes your body’s immune system to attack its own tissues, causing inflammation and damage. Lupus can attack any tissue or organ. Common targets of lupus include the skin and joints. In severe cases, lupus can attack the kidneys, heart, brain, nerves, and blood vessels.

Approximately 1.5 million Americans and 5 million people worldwide have lupus. About 90 percent of people with lupus are women. According to the Lupus Foundation of America, women who are African American, Hispanic/Latina, Asian American, Native American, Alaska Natives, Native Hawaiian, or other Pacific Islanders are two to three times more likely to develop lupus than white women. Most people with lupus develop their first symptoms between the ages of 15 and 44.

Symptoms of Lupus

Lupus symptoms vary widely depending on the part or parts of your body it affects. Your lupus symptoms may not be the same as someone else’s, even if you both have the same diagnosis. Your symptoms might affect individual parts of your body or they may affect your entire body.

Some of the most common symptoms of lupus are:

• Rashes, especially a butterfly-shaped rash on the face
• Joint pain
• Hair loss
• Mouth sores
• Fatigue (extreme tiredness)
• Weight loss
• Shortness of breath
• Facial swelling
• Swelling in hands or feet
• Memory problems or confusion

Lupus can also cause long-term health problems from ongoing inflammation, such as:

• Heart issues
• Kidney disease or damage
• Blood clots
• Anemia (low red blood cells)
• Lung inflammation
• Peripheral neuropathy (nerve problems)

Most people with lupus have times when their symptoms get worse, called flares, or flare-ups. During flares, inflammation increases, leading to more intense or new symptoms. In between flares, some people may feel better or have no symptoms at all.

Causes of Lupus

Experts aren’t sure what causes lupus, but they think several factors may play a role. Some of these factors include:

• Genetics — You’re more likely to get lupus if immediate family members have autoimmune diseases.
• Environment — Factors like sun exposure, air pollution, and other environmental factors may play a role.
• Behaviors —Smoking or taking certain medications may increase your risk.
• Hormones and health — Hormone imbalances and other autoimmune diseases may make you more likely to develop lupus.

Lupus flares often happen because of triggers — activities that cause or worsen symptoms. Triggers can be different for everyone, but common ones include:

• Sunlight or fluorescent light
• Exhaustion
• Emotional stress
• Infections
• Injuries
• Medications such as sulfa drugs, antibiotics, and diuretics (water pills)

Finding out what triggers your flare-ups and avoiding these triggers can help reduce how often they happen.

Lupus Types

There are different types of lupus, and symptoms can be different for each person. Some types of lupus only affect the skin, while systemic lupus erythematosus (SLE) attacks other types of tissues. The type of lupus someone has can change over time.

Here are the four main types of lupus:

Systemic Lupus Erythematosus

SLE is the most common type of lupus. It affects tissues in many parts of the body. Cases can range from mild to severe.

Cutaneous Lupus

Cutaneous lupus mainly affects the skin, especially after sun exposure. Its main symptoms are skin rashes and sores.

Drug-Induced Lupus

Drug-induced lupus appears as a side effect of some medications and is usually temporary. Symptoms typically start around 3 to 6 months after starting a medication and go away when you stop taking it.

Neonatal Lupus

Neonatal lupus is a rare form of lupus that affects newborn babies. Babies with mothers who have lupus are at a higher risk for developing neonatal lupus.

How Does Lupus Progress?

Lupus affects everyone differently. In mild cases, treatment can keep symptoms under control, and they may not worsen, or they might progress very slowly. However, some people can experience permanent damage over time, depending on which parts of the body lupus attacks. Some severe cases progress quickly.

About 50 percent of adults with lupus, and about 80 percent of children with lupus, will develop lupus nephritis (lupus that affects the kidneys). This can lead to serious complications, including kidney failure in about 10 percent to 30 percent of people with lupus nephritis, requiring dialysis or a transplant. Additionally, more than half of people with lupus develop heart issues, which can range from mild to serious.

Lupus can impact different organs depending on a person’s antibody profile, genetics and environmental factors. It can affect the brain, peripheral nervous system, components of blood, blood vessels, liver, and in some cases the digestive system.

How is Lupus Diagnosed?

Diagnosing lupus can be difficult because its symptoms vary widely. There isn’t a single test that can confirm that you have lupus. Your provider will start by doing a physical exam and discussing your symptoms. They may also recommend other tests to confirm or rule out that you have lupus. This process is known as a differential diagnosis.

Diagnosing lupus usually involves one or more of these types of tests:

• Blood tests — Blood tests can help check how well your immune system is working and identify different antibodies in your blood.
• Urinalysis — A urine test can show signs of infections and other possible symptom causes, like losing protein in urine.
• Biopsies — Tissue biopsies of the skin or kidneys can look for damage caused by autoimmune diseases, including lupus.
• Antinuclear antibody (ANA) tests — These tests look for antibodies that indicate an overactive immune system. Different types of antibodies can be present in people with lupus. Each of them can give insights into your condition.

Treatments for Lupus

While there is no cure for lupus, treatments can help manage symptoms and sometimes put the disease into remission. The main goal of lupus treatment is to reduce inflammation and prevent damage to organs and tissues. A good treatment plan can improve your quality of life.

You may need to see a rheumatologist in addition to your primary care provider. Rheumatologists specialize in diseases that affect the joints and muscles that are autoimmune in nature. Other specialists can provide care based on which parts of the body are affected by lupus.

A treatment plan for lupus might involve one or more of these medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) — These help reduce inflammation and pain.
• Corticosteroids — Corticosteroids such as prednisone reduce inflammation.
• Antimalarial medications — Drugs like hydroxychloroquine (Plaquenil) can help improve lupus symptoms and may help prevent complications like kidney disease. They are often prescribed when someone is first diagnosed with lupus.
• Immunosuppressants — These medications lower the activity of your immune system. There are several types of immunosuppressive medications used for lupus.
• Biologics — Drugs such as belimumab (Benlysta) and anifrolumab-fnia (Saphnelo), target parts of the immune system involved in lupus. They are usually given by intravenous injection.

Other medications may be used at the same time to target specific symptoms or complications from lupus.

It’s also important to understand your personal triggers — things that can worsen your symptoms — and try to avoid them. For example, if you have cutaneous lupus that is triggered by being in the sun, your doctor might suggest wearing sun-protective clothing or using sunscreen with a sun protection factor (SPF) of 50 or higher. These kinds of steps, along with eating an anti-inflammatory diet, managing stress, and doing light exercise regularly, can help your medications keep lupus under control.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 232,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

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