Lupus is a chronic, autoimmune disease that affects more women than men. If you have lupus, your risk is higher for other health problems that are common in women, such as heart disease and osteoporosis.
What is lupus?
Lupus is a chronic (lifelong) autoimmune disease that can damage any part of the body. With autoimmune diseases, the body’s immune (defense) system cannot tell the difference between viruses, bacteria, and other germs and the body’s healthy cells, tissues, or organs. Because of this, the immune system attacks and destroys these healthy cells, tissues, or organs.
What are the different types of lupus?
There are several different types of lupus:
- Systemic lupus erythematosus (SLE) is the most common and most serious type of lupus. SLE affects all parts of the body.
- Cutaneous lupus erythematosus, which affects only the skin
- Drug-induced lupus, a short-term type of lupus caused by certain medicines
- Neonatal lupus, a rare type of lupus that affect newborn babies
What is systemic lupus erythematosus (SLE)?
SLE is the most common type of lupus. SLE can be mild or severe and can affect different parts of the body. 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.
What is cutaneous lupus erythematosus (CLE)?
This type of lupus is a skin disease that can affect people with or without SLE. “Cutaneous” means “skin.” Symptoms may include rashes, hair loss, swelling of the blood vessels, ulcers, and sun sensitivity. To find out if you have cutaneous lupus and what kind it is, your doctor will remove a small piece of the rash or sore and look at it under a microscope.
There are two major kinds of cutaneous lupus:
- Discoid lupus erythematosus (DLE). A discoid rash usually begins as a red raised rash that becomes scaly or changes color to a dark brown. These rashes often appear on the face and scalp, but they may affect other areas. Many people with DLE have scarring. Sometimes DLE causes sores in the mouth or nose. If you have DLE, there is a small chance that you will later get SLE.
- Subacute cutaneous lupus erythematosus causes skin lesions that appear on parts of the body exposed to sun. These lesions do not cause scars.
What is drug-induced lupus?
Drug-induced lupus is caused by certain medicines. The symptoms of drug-induced lupus are like those of SLE, such as joint pain, muscle pain, and fever. But symptoms are usually not as serious. Also, drug-induced lupus rarely affects major organs. Most often, the disease goes away when the medicine is stopped.
The medicines that most commonly cause drug-induced lupus are used to treat other chronic health problems. These include seizures, high blood pressure, or rheumatoid arthritis. But not everyone who takes these medicines will get drug-induced lupus.
What is neonatal lupus?
Neonatal lupus is a rare condition in infants that is caused by certain antibodies from the mother. These antibodies can be found in mothers who have lupus. But, if you have lupus, this does not mean you will definitely pass it to your baby. Most infants of mothers with lupus are healthy.
It is also possible for an infant to have neonatal lupus even though the mother does not have lupus currently. But, if a baby is born with lupus, often the mother will develop lupus later in life.
At birth, an infant with neonatal lupus may have a skin rash, liver problems, or low blood cell counts. These symptoms often go away completely after several months and have no lasting effects. Infants with neonatal lupus also can have a rare but serious heart defect.
Who gets lupus?
Anyone can get lupus. It is difficult to know how many people in the United States have lupus, because the symptoms are different for every person. It is estimated that 1.5 million Americans have lupus.1 Other estimates range from 161,000 to 322,000 Americans with systemic lupus erythematosus (SLE).2
About 9 out of 10 diagnoses of lupus are in women ages 15 to 44.3
How does lupus affect women?
Lupus is most common in women ages 15 to 44, or during the years they can have children. Having lupus raises your risk of other health problems. Lupus can also make these problems happen earlier in life compared to women who do not have lupus.
These health problems include:
- Heart disease. Lupus raises the risk of the most common type of heart disease, called coronary artery disease (CAD). This is partly because people with lupus have more CAD risk factors, which include high blood pressure, high cholesterol, and type 2 diabetes. Lupus causes inflammation (swelling), which also increases the risk for CAD. Women with lupus may be less active because of fatigue, joint problems, and muscle pain, and this also puts them at risk for heart disease. In one study, women with lupus were 50 times more likely to have chest pain or a heart attack than other women of the same age.4
- Osteoporosis. Medicines that treat lupus may cause bone loss. Bone loss can lead to osteoporosis, a condition that causes weak and broken bones. Also, pain and fatigue can keep women with lupus from getting physical activity. Staying active can help prevent bone loss.
- Kidney disease. More than half of all people with lupus have kidney problems, called lupus nephritis.5 Kidney problems often begin within the first five years after lupus symptoms start to appear. This is one of the more serious complications of lupus. Also, kidney inflammation is not usually painful so you don’t know when it’s happening. That is why it’s important for people with lupus to get regular urine and blood tests for kidney disease. Treatment for lupus nephritis works best if caught early.
How does lupus affect women of color?
African-American and Hispanic women usually get lupus at a younger age and have more severe symptoms, including kidney problems, than women of other groups. African-Americans with lupus also have more problems with seizures, strokes, and dangerous swelling of the heart. Hispanic women with lupus also have more heart problems than women of other groups. Researchers think that genes play a role in how lupus affects minority women.
What causes lupus?
Researchers are still studying possible causes of lupus. We do know that lupus is not a disease you can catch from someone else. Genes play an important role but are not the only reason a person will get lupus. Even someone with one or more of the genes associated with lupus has only a small chance of actually getting the disease. Researchers are studying possible causes such as:
- The environment. Sunlight, stress, smoking, certain medicines, and viruses may trigger symptoms in people who are most likely to get lupus due to their genes.
- Hormones such as estrogen. Lupus is more common in women during their childbearing years when estrogen levels are highest.
- Problems with the immune system.
Lupus symptoms also usually come and go, meaning that you don’t have them all of the time. Lupus is a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better).
- Muscle and joint pain. You may experience pain and stiffness, with or without swelling. This affects most people with lupus. Common areas for muscle pain and swelling include the neck, thighs, shoulders, and upper arms.
- Fever. A fever higher than 100 degrees Fahrenheit affects many people with lupus. The fever is often caused by inflammation or infection. Lupus medicine can help manage and prevent fever.
- Rashes. You may get rashes on any part of your body that is exposed to the sun, such as your face, arms, and hands. One common sign of lupus is a red, butterfly-shaped rash across the nose and cheeks.
- Chest pain. Lupus can trigger inflammation in the lining of the lungs. This causes chest pain when breathing deeply.
- Hair loss. Patchy or bald spots are common. Hair loss could also be caused by some medicines or infection.
- Sun or light sensitivity. Most people with lupus are sensitive to light, a condition called photosensitivity. Exposure to light can cause rashes, fever, fatigue, or joint pain in some people with lupus.
- Kidney problems. Half of people with lupus also have kidney problems, called lupus nephritis.3 Symptoms include weight gain, swollen ankles, high blood pressure, and decreased kidney function.
- Mouth sores. Also called ulcers, these sores usually appear on the roof of the mouth, but can also appear in the gums, inside the cheeks, and on the lips. They may be painless, or you may have soreness or dry mouth.
- Prolonged or extreme fatigue. You may feel tired or exhausted even when you get enough sleep. Fatigue can also be a warning sign of a lupus flare.
- Anemia. Fatigue could be a sign of anemia, a condition that happens when your body does not have red blood cells to carry oxygen throughout your body.
- Memory problems. Some people with lupus report problems with forgetfulness or confusion.
- Blood clotting. You may have a higher risk of blood clotting. This can cause blood clots in the legs or lungs, stroke, heart attack, or repeated miscarriages.
- Eye disease. You may get dry eyes, eye inflammation, and eyelid rashes.
- Lawrence, R.C., Felson, D.T., Helmick, C.G., Arnold, L.M., Choi, H., Deyo, R.A., et al, for the National Arthritis Data Workgroup. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum; 58(1):26–35.
- Helmick, C.G., Felson, D.T., Lawrence, R.C., Gabriel, S., Hirsch, R., Kwoh, C.K., et al, for the National Arthritis Data Workgroup. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis Rheum; 58(1):15–25.
- Centers for Disease Control and Prevention. (2015). Systemic lupus erythematosus (SLE or lupus).
- Manzi, S, et al. (1997). Age-specific incidence rates of MI and angina in women with SLE: comparison with the Framingham Study. Am J Epidemiol; 145: 408-15.
- Lee, Y.H., Woo, J.H., Choi, S.J., Ji, J.D., Song, G.G. (2010). Induction and maintenance therapy for lupus nephritis: a systematic review and meta-analysis. Lupus; 19:703–710.
- Fernandez, M., Calvo-Alen, J., Alarcon, G.S., et al. (2005). Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXI. Disease activity, damage accrual, and vascular events in pre- and postmenopausal women. Arthritis Rheum;52:1655–1664.
- Dall’Era M. Chapter 21. Systemic lupus erythematosus. In: Imboden JB, Hellman DB, Stone JH. (Eds). Current Rheumatology Diagnosis and Treatment. 3rd ed. New York, NY:McGraw-Hill; 2013.
Source: https://www.womenshealth.gov/ Page last updated: July 12, 2018.