Commonly Presenting Symptoms

This site is intended for healthcare professionals as a useful source of information on the diagnosis, treatment and support of patients with lupus and related connective tissue diseases.

The most common symptoms of lupus are:-

Skin rashes – often a ‘butterfly’ rash over the cheeks and bridge of nose, although also seen in sun exposed areas such as the V of the neck and the forearms

Joints – aches and pains (arthralgias) can be experienced throughout the body. This does not usually lead to damage of the joints, although in some, swelling of the joints can be seen. In rare cases where damage is seen in the joints on x-ray, it may be associated with a secondary diagnosis of rheumatoid arthritis

Fatigue – described as excessive fatigue limiting everyday life

Feeling low in mood – although depression is common in lupus, this may be as a result of the diagnosis and symptoms, particularly if they are unpredictable and impact on daily life activities. True clinical depression is seen less frequently in lupus and may require treatment by local GP

Migraines/headaches – the ‘lupus migraine’ is described as one that does not respond to conventional pain killers and can last for lengthy periods

Hair loss – a distressing symptom, where large clumps of hair are seen on the pillow and in the plug after a shower/bath

Mouth ulcers – recurrent crops of mouth ulcers that do not heal

Dry eyes and dry mouth – often worse in those who carry the Ro/La antibodies, this symptom is uncomfortable and can be difficult to treat

Kidneys – often detected thorough urine dipstick and can vary from mild to a severe form that could cause kidney failure

Circulation can be affected and can be seen as:
    o Clotting problems, often seen as a reduction in platelets
    o Blood clots in those with antiphospholipid syndrome
    o Cold hands and feet – Raynaud’s phenomenon is seen in some people with lupus where the fingers in particular change colour as a response to the cold and stress. The usual colour changes are white, dark blue and then bright red (when pain can be felt at this point)

Heart and lungs – a variety of different symptoms can be seen, such as:
    o Breathlessness and sharp pains in the chest. These can be as a result of either pericarditis (inflammation of the lining of the heart) or pleurisy (inflammation of the lung)
    o Heart attacks and stroke carry an increased risk in lupus, especially in women under the age of 40
    o High blood pressure can be present when the kidneys are involved or secondary to the use of long-term steroids

Brain – this is a rare complication and the one that most patients are most worried about. Symptoms can be varied but can include fits and seizures, severe memory loss and other psychiatric complications.