Lupus

Lupus is a chronic autoimmune illness. This means that your immune system attacks your body's normal cells. It can affect different parts of your body.

Lupus is more common in females. It mostly affects people between 20 to 40 years old but can also occur in newborns, children and older adults.

What are the types of lupus?

There are several types of lupus. The 2 main types are systematic lupus erythematosus (SLE) and discoid lupus.

• Systemic lupus erythematosus (SLE) can affect almost any organ or body system. It mostly affects your skin and joints. For some people, lupus may also affect their heart, blood vessels, lungs, kidneys or brain.
• Discoid lupus is usually is a milder illness. It often only affects your skin, though it can sometimes develop into SLE.
• Subacute cutaneous lupus is milder and mostly causes rashes and joint pain.
• Drug-induced lupus develops as a reaction to certain medicines. It usually gets better after you stop taking the medicine that triggered it.
• Neonatal lupus erythematosus (NLE) can happen if certain antibodies (a type of protein in your blood) pass to the baby during pregnancy. This can lead to skin rashes, liver and blood problems and sometimes heart problems.

Symptoms of lupus may vary widely. Some people have mild symptoms, while others may have more severe symptoms.

Most people with lupus have symptoms affecting their skin and mucous membranes (the lining of parts of the body), such as:

• rashes — especially a butterfly-shaped rash on the face
• mouth and nose ulcers
• hair loss

Other symptoms of lupus may include:

• joint pain or swelling
• Raynaud's phenomenon, where fingers and toes turn white or blue in response to cold or stress
• swollen lymph nodes and spleen
• fatigue and feeling unwell
• fever
• loss of appetite and weight loss

Most people will not experience all these symptoms and may have different symptoms at different times. For some people, symptoms may ease after treatment of an initial attack. Others may have periods of improvement (remission), followed by flare-ups.

The exact cause of lupus is unknown. Lupus may be caused by a combination of genetic, hormonal and environmental factors. You are more likely to have lupus if someone genetically related to you has it.

Lupus develops if your immune system makes antibodies that attack your normal body cells. This leads to inflammation, pain and damage in the parts of your body that are affected.

Several factors may trigger lupus, such as:

• hormones — females, especially those of childbearing age, have a higher risk than males, suggesting hormones like oestrogen may play a role
• environment — exposure to too much sunlight, some viral infections or chemicals
• medicines — some medicines may trigger lupus, which usually goes away once you stop taking the medicine

What causes lupus to flare up?

Symptom flare-ups in lupus can be triggered by various factors, including:

• certain foods
• medicines and chemicals
• stress
• pregnancy
• hormones
• sun exposure
• viral and bacterial infections

See your doctor if you have symptoms of lupus, to work out what is causing them.

If you have lupus, talk to your doctor if you are planning to become pregnant. Your doctor can help you get your symptoms under control before pregnancy. They can also check that any medicines you take are safe during pregnancy.

The diagnosis is based mainly on your doctor talking to you and examining you. They will ask you questions about your symptoms and refer you for tests.

Tests may include a:

• blood test called an anti-nuclear antibody (ANA) test (Opens in new tab), which checks if you have antibodies to your own cells
• urine test
• chest x-ray
• electrocardiogram (ECG) or echocardiogram to check how well your heart is working
• biopsy

There is no single test that gives a diagnosis of lupus. Sometimes, the diagnosis can't be made straight away — it may take time.

The main goal of lupus treatment is to reduce inflammation in the body and improve quality of life. There is no cure for lupus, but medicines are available to help manage it.

Being physically active and making lifestyle changes can also help you manage your symptoms.

Treatment is different for each person and depends on how severe your lupus is. Your doctor may refer you to a rheumatologist (a specialist in joint inflammation).

Medicines

Medicines may help manage your symptoms and can help control your overactive immune system. Medicines may include:

• pain-relief medicine — for joint and muscle pain
• non-steroidal anti-inflammatory medicines (NSAIDs) — to help control inflammation and provide pain relief
• hydroxychloroquine (a medicine also used to treat malaria) — to help control your overactive immune system
• corticosteroids, such as prednisolone — to reduce inflammation
• disease modifying anti-rheumatic medicines (DMARDs) — to help control your immune system and relieve pain and inflammation
• immunosuppressants — medicines to help control your immune system

Lifestyle

You can help control lupus by following these lifestyle measures:

• Get plenty of rest.
• Avoid and manage stress.
• Get regular moderate exercise — without becoming too tired.
• Maintain a healthy diet.
• Quit smoking.
• Avoid drinking too much alcohol.
• Protect your skin from the sun and reduce your exposure to sunlight.

Living with lupus means finding ways to manage your symptoms and support your overall wellbeing. Here are practical ways to help you manage life with lupus:

• Learn as much as you can about lupus.
• Work out what triggers your lupus, so you can avoid it.
• Work closely with your doctors.
• Always take your medicines as instructed.

You may want to join a lupus support group.

Lupus can lead to various complications. It may affect major organs, mental health and overall immune function. It can also lead to challenges related to pregnancy.

People with lupus may develop:

• organ damage — especially to the kidneys, heart and lungs
• blood disorders — such as anaemia, high blood pressure or blood clots
• mental health problems — such as depression and anxiety
• nervous system complications — such as seizures or vision problems
• infections
• osteoporosis
• pregnancy complications — such as pre-eclampsia, preterm labour (Opens in new tab) and an increased risk of miscarriage (Opens in new tab)

Lupus cannot be prevented because its exact cause is unknown. Understanding the risk factors can help you prevent it getting worse.

Lupus Australia (Opens in new tab) offers resources about:

• living with lupus (Opens in new tab)
• managing pain (Opens in new tab)
• healthy eating (Opens in new tab)

Join a lupus support group near you:

• Lupus Victoria (Opens in new tab)
• Lupus WA (Opens in new tab)
• Arthritis Queensland (Opens in new tab)
• Musculoskeletal Health Australia (Opens in new tab)

You can also call the healthdirect helpline on 1800 022 222 (Opens in new tab) (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Staying Strong with Arthritis (Opens in new tab) provides information about lupus for Aboriginal and/or Torres Strait Islander people.