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Lupus

Systemic lupus erythematosus (SLE, now known more commonly as lupus) is a long-term systemic condition. It causes a range of symptoms in different parts of the body, including the skin, joints and organs.

  1. Can cause a wide variety of symptoms
  2. Autoimmune condition for which the cause is unknown
  3. Treatment available to alleviate symptoms

People who are concerned about symptoms and want to get advice, or who have been diagnosed with lupus and want to speak to someone, can do so through our online video consultation service. Book an appointment at a convenient time for you. 

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Description

What is lupus?

Lupus, or systemic lupus erythematosus (SLE), is a chronic condition that can affect several different parts of the body. In lupus, the immune system attacks one or more organs (for example the skin or the kidneys), causing inflammation, and sometimes stopping them from working properly. Although it is a potentially severe condition, early diagnosis and effective management has led it to no longer being a life-threatening condition in most cases.

It’s thought that about 15,000 people in the UK have the condition. 9 in 10 of those with the condition are women. People from African, Caribbean or Asian ethnic backgrounds are more likely to develop lupus than white Europeans.

What symptoms does lupus cause?

The most common symptoms of lupus are a rash (characteristically known as a butterfly rash, this appears on the nose and cheeks), feeling very tired (fatigue) and pain in the joints. However, it can also cause a range of other symptoms, including (but not limited to) high blood pressure, fever, hair loss and migraines.

Because the symptoms are so varied, lupus is often mistaken for other conditions and vice versa.

There is no one single test for lupus. Diagnosis is usually made through a combination of blood tests and scans. There are certain antibodies that people with lupus have, which are visible in a blood test. Imaging tests like x-rays may be used to examine how the disease is affecting the body.

The cause of lupus is unknown. However, several triggers have been identified. When someone with lupus comes into contact with sunlight, a change in hormone levels (such as those experienced during puberty, pregnancy or the menopause) or an infection, the condition can flare up.

What complications can lupus lead to?

There are several possible complications associated with lupus. Around 1 in 3 people develop problems with their kidneys, leading to a condition called lupus nephritis. It usually develops in the early stages of lupus and often leads to swelling of the feet, headache and blood in the urine. 

Someone with lupus is more likely to develop cardiovascular disease, as it can inflame the heart and arteries. Leukopenia (a decrease in the amount of white blood cells) and thrombocytopenia (a very low level of platelets in the blood) are blood disorders that can occur in people with lupus.

There are treatments that can help to stop the condition from progressing. Immunosuppressant medicine works by stopping the body’s defences from attacking the organs affected, thereby reducing the effects of the disease. Other treatments may also be advised to target specific symptoms. For example, steroids might be used to help with skin symptoms, while anti-inflammatories can help with painful or swollen joints. Hydroxychloroquine, traditionally a malaria drug, may help to tackle a rash, joint pain and fatigue.

Can I get advice about lupus online?

If you are experiencing symptoms, such as tiredness or a rash, and want to speak to a doctor online, our video consultation service enables you to do so. Those who have already had a lupus diagnosis and want to speak to someone about their treatment can also chat to one of our doctors online. Book a slot at a time suitable for you.

Page last reviewed:  15/06/2020
Diagnosis and treatment

What are the causes of lupus?

Symptoms of lupus can occur when the immune system attacks a particular part of the body. 

As is the case with many autoimmune conditions, it isn’t entirely clear what causes lupus, but it is thought that people who are genetically predisposed to the condition will develop it in response to environmental triggers. The use of certain medicines, puberty, childbirth, the menopause, viral infections, and exposure to sunlight are all potential triggers.

How is lupus diagnosed?

Diagnosing lupus isn’t straightforward. Common symptoms of the condition are fatigue, a rash and joint pain. Other symptoms include headaches, migraines, high blood pressure, fever, swollen glands, chest pain and seizures. Because the symptoms are so diverse, it can be difficult to distinguish between lupus and a wide number of other illnesses.

Lupus can cause a characteristic rash to develop on the face, which's known as the butterfly rash. However, it is thought to affect only around 40% of people with the condition. It spreads from the cheeks across the nose (in a pattern that looks like a butterfly).

Will I need tests?

If a doctor suspects you have lupus, you will need to have tests. A clinician will take a blood test to look for the antinuclear antibody (around 19 in 20 people with lupus have this antibody) and also a secondary antibody called anti-double-stranded DNA (anti-dsDNA). There are various other antibodies associated with lupus, but these two are the most common.

It’s likely that a doctor will take urine samples to see if the kidneys have been affected. Following a diagnosis, someone with lupus will need regular check-ups to assess the activity of the disease. These tests include imaging scans such as x-rays and MRIs, along with regular blood tests.

How is lupus managed?

Lupus can be a complex condition, and treatment depends on how it affects the individual. There is no cure, but symptoms can be controlled with the right course of medication. Most people with the condition will be referred to a specialist, who can recommend how to manage possible flare-ups.

Immunosuppressant drugs may help to limit the activity of the condition. This might involve drugs such as azathioprine or methotrexate, or biologic therapies like rituximab.

Symptom-specific treatment may also be recommended. The most common treatments for joint problems are non-steroidal anti-inflammatory drugs (NSAIDs) which can ease the pain from the muscles and joints in lupus. For skin-related symptoms, a doctor may suggest a course of corticosteroids, such as Prednisolone.

Page last reviewed:  15/06/2020
Questions and Answers

How is lupus treated?

Treatment varies significantly for lupus, as it can affect the body in many different ways. In the long term, medication that helps to suppress the immune system may be recommended, to help stop the disease from attacking the body. This includes drugs like methotrexate and rituximab. 

If lupus causes certain symptoms, specific treatment will be offered. For example, NSAIDs might be used for joint pain, and steroids for skin problems.

What is the prognosis for people with lupus?

It depends on how severe the disease is. Treatment for the condition has advanced in recent years, so it is much more treatable now than it has been previously. 

However, the condition will need ongoing monitoring and management, to ensure that complications do not develop. 

Can I consult a doctor about lupus online?

If you have any of the symptoms discussed, such as fatigue or a rash, or are otherwise concerned, you can speak to a doctor online about potential lupus symptoms through our video consultation service. Our UK doctors are able to provide advice on treatment, or refer you to a specialist where required.

Page last reviewed:  15/06/2020

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