Lupus Symptoms, Signs, and Complications
Lupus can affect many different parts of the body so the the disease has many signs and symptoms. Lupus symptoms tend to present themselves according to the body system affected. These symptoms vary over time in intensity and duration for each patient as well as from patient to patient.
Early lupus symptoms might be vague, nonspecific, and easily confused with other pathological and functional disorders. Lupus symptoms may be transient or prolonged, and individual symptoms often appear independently of the others. Moreover, a patient may have severe symptoms with few abnormal laboratory test results, and vice versa. The list below shows the range of clinical symptoms seen in patients with lupus over the lifetime of the disease.
Symtoms of Lupus (SLE)
- Achy/Painful Joints (Arthralgia)
- Fever (>100 °F)
- Arthritis (Achy or swollen joints)
- Extreme or Chronic Fatigue
- Skin rashes
- Kidney Problems
- Chest Pain When Breathing (Pleurisy)
- Facial Butterfly Rash
- Light or Sun Sensitivity (Photosensitivity)
- Hair Loss (Alopecia)
- White or Blue Fingers (Raynaud’s phenomenon)
- Mouth or nose ulcers
Lupus Symptoms by Body System
The pages in the rest of this section provide an overview of general and system-specific lupus symptoms and identifies potential problems. More detailed information on each class of symptom can be found by clicking on the links in the menu.
- Body Wide – Fatigue, fever, and Infection
- Dermatologic – butterfly rash, photosensitivity, Discoid LE, subcutaneous LE, mucosal ulcers, alopecia, bruising
- Musculoskeletal – arthralgias, arthritis, other joint complications
- Hematologic – anemia, decreased white blood cell (WBC) count, thrombocytopenia, lupus anticoagulants, false-positive venereal disease research laboratory test (VDRL), elevated erythrocyte sedimentation rate (ESR), lymphopenia
- Cardiopulmonary – pericarditis, myocarditis, myocardial infarction, vasculitis, pleurisy, valvular heart disease
- Renal – asymptomatic microscopic renal involvement, renal failure, fluid and electrolyte imbalance, edema
- Central Nervous Systems – cranial neuropathies, cognitive impairment, mental changes, seizures, stroke, peripheral neuropathy, meningitis, coma, psychosis
- Gastrointestinal – anorexia, ascites, pancreatitis, mesenteric or intestinal vasculitis
- Ophthalmologic – cytoid bodies, dry eyes
Other Key Lupus Issues
- Pregnancy – lupus flare, miscarriage or stillbirth, pregnancy-induced hypertension, neonatal lupus
- Infection – increased risk of respiratory tract, urinary tract, and skin infections; opportunistic infections
- Nutrition – weight changes, poor diet, appetite loss
Suggested health care interventions for the non-hospitalized lupus patient are listed in the subsequent pages. Many of these interventions can be modified for the hospitalized patient. The information and nursing interventions described in this chapter are not meant to be inclusive, but to provide the patient with an idea of the guidelines that your healthcare professional will keep in mind while developing a care plan specific to the needs of each lupus patient.
As a care plan is developed, your health professional should keep in mind the importance of frequently reassessing the patient’s status over time and adjusting treatment to accommodate the variability of systemic lupus erythematosus (SLE) manifestations. An additional and very important element of working with the lupus patient is to incorporate the patient’s needs and routines in the plan of care.
Adjusting nursing interventions and medical protocols to the patient’s needs not only recognizes the value of the patient as an authority on her or his own illness, but also can improve patient compliance and result in an improved quality of life.
Working together, the care provider and the patient have much to offer each other. The rewards for patients and families are tremendous, as patients become more independent and gain confidence in being able to care for themselves.