Lupus is known as "the great imitator" because its symptoms mimic many other illnesses. Lupus symptoms can also be unclear, can come and go, and can change. On average, it takes nearly six years for people with lupus to be diagnosed, from the time they first notice their lupus symptoms.
Lupus can be hard to diagnose because it has many symptoms that are often mistaken for symptoms of other diseases. Many people have lupus for a while before they find out they have it. If you have symptoms of lupus, tell your doctor right away. No single test can tell if a person has lupus.
A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth sores.
Lupus is different for every person. Some people's lupus symptoms don't ever fully go away, or they often have flares. Others will have flares every few years (or even less often) and their lupus will be inactive the rest of the time.
Kidneys About one half of people with lupus experience kidney involvement, and the kidney has become the most extensively studied organ affected by lupus. Lungs About 50% of people with SLE will experience lung involvement during the course of their disease.
One person with lupus may experience malar rashes, kidney involvement, and memory loss, while another can have seizures, pleurisy, or hair loss. Though any of these symptoms could be a manifestation of lupus, they also could signal another, problem.
Antibody blood tests
The test you will hear about most is called the antinuclear antibodies test (the ANA test). 97% of people with lupus will test positive for ANA.
Lupus can affect almost any organ in your body.
For example, one person with lupus may have swollen knees and fever. Another person may be tired all the time or have kidney trouble. Someone else may have rashes. Over time, new symptoms can develop or some symptoms may happen less often.
Sjogren's syndrome is a relatively common disease, although often under-diagnosed. Sjogren's syndrome can occur alone or in association with other autoimmune diseases, most commonly lupus and rheumatoid arthritis (RA).
Common symptoms include fatigue, hair loss, sun sensitivity, painful and swollen joints, unexplained fever, skin rashes, and kidney problems. There is no one test for SLE. Usually, your doctor will ask you about your family and personal medical history and your symptoms. Your doctor will also do some laboratory tests.
Signs and symptoms of lupus may change over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis.
For example, untreated lupus can lead to blood disorders such as anemia or thrombosis. Other potential serious complications include: Chronic digestive distress that could include difficulty swallowing, dry mouth, indigestion, intestinal inflammation, liver enlargement, or pain when vomiting or feeling nauseous.
Cutaneous lupus (skin lupus) can cause irritating and unsightly rashes. Untreated, these rashes can cause long-term damage, such as permanent hair loss, scarring and skin discoloration. Some types of cutaneous lupus can develop into skin cancer.
98% of all people with systemic lupus have a positive ANA test, making it the most sensitive diagnostic test for confirming diagnosis of the disease. The test for anti-nuclear antibodies is called the immunofluorescent antinuclear antibody test. In this test, a blood sample is drawn and sent to a laboratory.
Lupus often causes skin rashes, arthritis, mouth sores, sun sensitivity, hair loss, or kidney problems, but these symptoms don't show up in MS. Even when lupus affects your nervous system, its most common symptoms are migraine, personality changes, seizures, or stroke, but these aren't typical for MS.
A doctor may use the phrase "borderline lupus" when symptoms or blood test results suggest lupus, but there is not enough information for a definite diagnosis.
Ninety percent of people with lupus will experience general fatigue and malaise at some point during the course of the disease. Some people find a short 1 ½ hour afternoon nap to be effective in reducing fatigue.
The effects lupus may have in and around the eyes include: changes in the skin around the eyelids, dry eyes, inflammation of the white outer layer of the eyeball, blood vessel changes in the retina, and damage to nerves controlling eye movement and affecting vision.
Almost everyone with lupus has joint pain and swelling, but depending on what part of your body the lupus is attacking, you could have other symptoms too. If it's your skin, you might have a rash on your face and body. If lupus attacks your digestive tract, you might feel sick to your stomach.
Undifferentiated Connective Tissue Disease
“There are people who have a milder form of an autoimmune disease who just don't meet the classification criteria for lupus. We call that undifferentiated connective tissue disease (UCTD),” says Dr. Petri.
Viruses that have been linked to lupus include: Cytomegalovirus. Epstein-Barr virus, which causes mononucleosis. Varicella-zoster virus, which causes chickenpox and shingles.
Patients who have fewer symptoms than required to meet classification criteria are said to have “pre-lupus,” “incomplete lupus,” “evolving lupus,” forme fruste lupus (a French term that translates as “incomplete or unfinished form”), or undifferentiated connective tissue disease (UCTD).