Overview of Systemic Lupus Erythematosus (Lupus)

Systemic lupus erythematosus (lupus) is a chronic (long-lasting) autoimmune disease that can affect many parts of the body. Lupus occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues. This attack causes inflammation, and in some cases permanent tissue damage, which can be widespread – affecting the skin, joints, heart, lung, kidneys, circulating blood cells, and brain.

If you have lupus, you may experience periods of illness (flares) and periods of wellness (remission). Lupus flares can be mild to serious, and they are unpredictable. However, with treatment, many people with lupus can manage the disease.

Who Gets Systemic Lupus Erythematosus (Lupus)?

Anyone can get lupus; however, women get the disease about nine times more often than men.  Most often it happens in people between ages 15 and 45 years, but lupus can occur in childhood or later in life as well.  

Lupus is more common in African Americans than in White people and is also more common in people of American Indian and Asian descent. Men, African Americans, Chinese people, and Hispanic people are also more likely to have serious organ system involvement. If you have a family member with lupus or another autoimmune disease, you may be more likely to develop lupus.

Symptoms of Systemic Lupus Erythematosus (Lupus)

The symptoms of lupus vary from person to person and can range from mild to severe. You may have just a few symptoms affecting just one area of your body, or you could have many symptoms throughout your body. Symptoms may come and go, and you may develop new symptoms over time. Some symptoms happen when the disease causes inflammation in organs, such as the joints, skin, kidneys, lining of the heart and lungs, brain, and blood cells. Symptoms of lupus can include:

  • Arthritis, causing painful and swollen joints and morning stiffness.
  • Fevers.
  • Fatigue or feeling tired often.
  • A rash that appears on the face across the nose and cheeks; this is called a malar or “butterfly” rash
  • Round scaly rashes that can appear anywhere on the body.
  • Sensitivity to the sun that may cause a rash.
  • Hair loss.
  • Sores, which are usually painless, in the nose and mouth (most often on the roof of the mouth).
  • Change of color in the fingers and toes – blue-purplish, white, or red – from cold and stress (Raynaud’s phenomenon).
  • Swollen glands.
  • Swelling in the legs or around the eyes.
  • Pain when breathing deeply or lying down, from inflammation of the lining around the lungs or heart.
  • Headaches, dizziness, depression, confusion, or seizures.
  • Abdominal pain.

Lupus causes inflammation throughout the body, which can cause problems in organs, including:

  • Kidney damage that can lead to changes in kidney function, including kidney failure. This is called lupus nephritis.
  • Seizures and memory problems due to changes in the brain and central nervous system.
  • Heart problems:
    • Heart valve damage due to inflammation that leads to scarring.
    • Inflammation of the lining around the heart muscle, called pericarditis.
    • Inflammation of the heart muscle itself, called myocarditis
  • Inflammation of blood vessels, called vasculitis.
  • Blood clots due to high levels of certain autoantibodies referred to as antiphospholipid antibodies.
  • Low blood cell counts, including red blood cells, white blood cells, and platelets.
  • Inflammation of the tissue that surrounds the lungs, making it painful to breathe. This is called pleurisy.

Some people with lupus may be more likely to develop other conditions, such as cardiovascular disease due to inflammation of the heart and blood vessel tissues caused by lupus, which can lead to:

  • Atherosclerosis, which happens when fat and other materials attach to the blood vessel wall and form plaque. This can happen in blood vessels throughout the body.
  • Coronary artery disease, which happens when plaque builds up in the arteries that supply blood to the heart. This can interrupt blood flow when a blood clot forms or a piece of plaque breaks off, causing a heart attack.

Causes of Systemic Lupus Erythematosus (Lupus)

The cause of lupus is unknown, and researchers are still trying to learn what may trigger or lead to the disease. Doctors know that it is a complex autoimmune disease in which the body’s immune system attacks the person’s tissues and organs. Studies show that certain factors may trigger your immune system, causing the disease. These factors include:

  • Genes. Research shows that certain genes play a role in the development of lupus. The different forms of these genes carry instructions for proteins that may affect the immune system. Researchers are studying how high levels or low levels of these proteins may be important in the development of the disease.  
  • Environment. Exposure to certain factors in the environment – such as viral infections, sunlight, certain medications, and smoking – may trigger lupus.
  • Immune and Inflammatory Influences. Researchers think that if the body does not remove damaged or dead cells normally, this could trick the immune system into constantly fighting against itself. This process could cause an autoimmune response, which could lead to lupus. In addition, researchers are studying different cell types and how changes could lead to lupus.