by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Many people looking for in formation on lupus will be in a hurry and miss the “m” in symptoms as they type the words for an internet search.
Important information from the Arthritis Foundation
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease due to the formation of anti-DNA antibodies that attack the host.
This is one of the most common and certainly one of the most prominent features of lupus. Patients often describe it as an "unnatural" fatigue. Often it precedes the diagnosis by months or years.
Aches and pains
The majority of lupus patients suffer at some stage from joint and muscle pains. In many patients this presents as 'pain all over'. In acute flares of lupus the symptoms are often described as being 'flu-like'. It is not just the joints that are affected but the tendons and muscles as well. In the majority of cases the joint inflammation does not progress to permanent damage.
Fever is usually a feature of a flare of the disease. Fever is unusual when the disease is in a quiet phase: thus in an adult or a child known to have lupus who develops fever the possibility that an infection might be present always needs consideration.
A wide variety of skin rashes occur in lupus. Traditionally these are sun-sensitive (photosensitive) but this is not always the case. The commonest rashes are on the cheeks (the butterfly rash across the nose and cheeks), on the elbows, on the palms and soles and on the V-neck area. The rashes vary from pinkish discoloration to blisters and small pinpoint 'blood spots' (purpura).
Hair loss is one of the most important features of active lupus. It may be the first manifestation of the disease and is often first noticed by the patient as hair on the pillow. In some cases hair loss is patchy and even extreme. Fortunately, in the vast majority of patients the hair re-grows after successful treatment.
Headaches are a major feature of lupus. In some patients a history of headaches or atypical migraine go back to the patient's teens and pre-date the diagnosis by many, many years. There are many causes of headaches in systemic lupus. One specific and important cause is antiphospholipid antibodies.
Apthous sores in the mouth are a common symptom. Unlike most mouth sores, these are usually painless. Sore throats are also a common symptom.
Depression is an important feature of lupus. It is sometimes simply attributed to 'being unwell' or having tiredness and pain. It sometimes responds well to management of the lupus itself and is clearly a central feature of the lupus process. In some patients the return of depression is a sign that the lupus is flaring.
As almost every organ in the body may be affected at some time, the symptoms and signs include irritation of the eyes (sometimes associated with dry eyes), mouth ulcers, chest pain (pleurisy is, for example, important in active lupus), weight loss and ankle swelling.
The diagnosis of lupus is usually made on clinical grounds. The combination of some of the features described above, especially the skin rashes, usually but not always makes the diagnosis clear. Unfortunately, in many patients, especially those who do not have the classical tell-tale rashes, the diagnosis is missed. This is particularly true for those with more 'vague' symptoms such as fatigue, depression or headaches. Often the patients are given the wrong diagnosis such as ME or 'atypical multiple sclerosis'. Diagnosis is critical and any individual in whom lupus is suspected (or for that matter the relative or offspring of any individual with lupus in whom the diagnosis is a consideration) should have the simple blood tests performed.
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