Lupus is a disease that can affect people of all ages, races, and ethnicities. The signs and symptoms mimic those of other diseases, making it hard to diagnose. Learn more.

What Is Lupus?

Lupus is a chronic, autoimmune disease that affects many different parts of the body. An autoimmune disease occurs when the body’s immune system attacks itself because it cannot tell the difference between healthy tissue and foreign invaders, such as bacteria and viruses.

Lupus symptoms can show up in many different ways and are often mistaken for symptoms of other diseases. This is why it can be hard to diagnose and is often called “the great imitator.” Lupus symptoms can range from mild to life threatening, so early diagnosis and treatment by a rheumatologist are important. A rheumatologist is a doctor who has additional training and experience in the diagnosis and treatment of arthritis, lupus, and other diseases of the joints, muscles, and bones.

Lupus Health Disparities

Systemic lupus erythematosus, or SLE, is the most common type of lupus and can affect multiple organs. While SLE can occur in anyone, it is more common among Black and Latina women and women of childbearing age (15 to 44).  Ninety percent of people with lupus are women. Among women, Black and Latina women are 2 to 3 times more likely than White women to develop lupus and have more severe disease progression. In a study examining death rates among people with SLE, Black people had higher rates of death than White people, and deaths occurred sooner after diagnosis. Among those with SLE, Black people were significantly younger when they died than White people (average age of 52 vs. 64).

Signs and Symptoms of Lupus

People with SLE can have many different symptoms, including:

• Fatigue or extreme exhaustion no matter how much they sleep
• Muscle and joint pain or swelling
• Skin rashes (in particular a butterfly-shaped face rash across the cheeks and nose)
• Fever
• Hair loss
• Recurring mouth sores

Additional symptoms or conditions can include:

• Sensitivity to the sun
• Lung problems
• Chest pain when deep breathing
• Fingers or toes turning blue or white or feeling numb
• Heart problems
• Kidney problems
• Psychosis (disruptive thoughts and perceptions about what is or is not real)
• Blood cell and immunological abnormalities (anemia or clotting problems)
• Eye diseases
• Memory problems

People with SLE can have periods of lupus symptoms called flares, followed by symptom-free periods called remissions. They may have flares often, or years apart, throughout their life and with varying severity. There is no cure for SLE, but many people with the disease can manage their symptoms with proper treatment and lead a full, happy life. Getting an early diagnosis and getting treatment are critical to preventing long-term consequences and managing symptoms.

How Is Lupus Diagnosed?

There is no single test for SLE. To diagnose SLE, a doctor will take into account the patient’s symptoms, signs observed during physical exams, and the results of X-rays and lab tests. SLE may be hard to diagnose because its signs and symptoms are not specific and can look like signs and symptoms of other diseases. SLE may also be misdiagnosed, so it is important to see a doctor who specializes in rheumatology for a second opinion.

Other Types of Lupus Among Adults

• Cutaneous lupus (skin lupus) affects the skin in the form of a rash or lesions. This type of lupus can occur on any part of the body but usually appears where the skin is exposed to sunlight.
• Drug-induced lupus is similar to SLE, but it is caused by a reaction to some medicines. Symptoms usually appear 3 to 6 months after starting a medicine and disappear once the medicine is stopped.

How Is Lupus Treated?

Although there is no cure for lupus, it can be managed with proper treatment, and people with lupus can go on to live long, happy lives. The goals of treatment are to manage current symptoms, prevent future flares, and prevent damage to joints and organs by calming the immune system. Because the symptoms of lupus vary widely, management depends on a person’s individual symptoms and needs. Seeing a doctor regularly and following the prescribed course of treatments is important. Beyond that, adopting healthy behaviors and learning skills to manage the disease can also be beneficial.

To improve overall health and quality of life, people with lupus should:

• Be physically active
• Eat healthy meals
• Get plenty of rest
• Avoid smoking
• Wear sunscreen and avoid excessive sun exposure

Self-management education workshops, such as the Chronic Disease Self-Management Program, can help people with lupus learn how to manage daily life, medications, and interactions with doctors, as well as improve energy and pain management.

Yes. Women with lupus can safely become pregnant. If your disease is under control, pregnancy is unlikely to cause flares. However, you will need to start planning for pregnancy well before you get pregnant. 

• Your disease should be under control or in remission for six months before you get pregnant. Getting pregnant when your lupus is active could result in miscarriage, stillbirth, or other serious health problems for you or your baby.
• Pregnancy is very risky for certain groups of women with lupus. These include women with high blood pressure, lung disease, heart failure, chronic kidney failure, kidney disease, or a history of preeclampsia. It also may include women who have had a stroke or a lupus flare within the past six months.

You will need to find an obstetrician (a doctor who is specially trained to care for women during pregnancy) who manages high-risk pregnancies and who can work closely with your regular doctor.

Pregnant women with lupus have a higher risk for certain pregnancy complications than women who do not have lupus. You may also have other problems that happen during pregnancy.

• You may get flares during pregnancy. The flares happen most often in the first or second trimester. Most flares are mild. But some flares require medicine right away or may cause you to deliver early. Always call your doctor right away if you get the warning signs of a lupus flare.
• About 2 in 10 pregnant women with lupus get preeclampsia, a serious condition that must be treated right away. The risk of preeclampsia is higher in women with lupus who have a history of kidney disease. If you get preeclampsia, you might notice sudden weight gain, swelling of the hands and face, blurred vision, dizziness, or stomach pain. You might have to deliver your baby early.
• Pregnancy can raise your risk for other problems, especially if you take corticosteroids. These problems include high blood pressure, diabetes, and kidney problems. Good nutrition during pregnancy can help prevent these problems during pregnancy. Regular doctor visits can help find problems like these early so they can be treated to keep you and your baby as healthy as possible.

You may not be able to tell the difference between changes in your body due to pregnancy and warning signs of a lupus flare. Tell your doctor about any new symptoms. You and your doctor can figure out whether your symptoms are because of your pregnancy or your lupus. This way, you can help prevent or control any flares that do happen.

Most likely, yes. Most babies born to mothers with lupus are healthy.

Rarely, infants are born with a condition called neonatal lupus. Certain antibodies found in the mother can cause neonatal lupus. At birth, an infant with neonatal lupus may have a skin rash, liver problems, or low blood cell levels.

Infants with neonatal lupus can develop a serious heart defect called congenital heart block. But, in most babies, neonatal lupus goes away after three to six months and does not come back.

Your doctor will test for neonatal lupus during your pregnancy. Treatment can also begin at or before birth.

Yes. Breastfeeding is possible for mothers with lupus. However, some medicines can pass through your breastmilk to your infant. Talk to your doctor or nurse about whether breastfeeding is safe with the medicines you use to control your lupus.

Congratulations, you’re pregnant! Pregnancy is an exciting time, but it can also be stressful. Knowing that you are doing all you can to stay healthy during pregnancy and give your baby a healthy start in life will help you to have peace of mind.

What Are Steps You Can Take Toward a Healthy Pregnancy?

Folic Acid: Folic acid is a B vitamin that can help prevent major birth defects. Take a vitamin with 400 micrograms (mcg) of folic acid every day, before and during pregnancy.

Smoking: The best time to quit smoking is before you get pregnant, but quitting at any time during pregnancy can help your baby get a better start on life. Learn more about the dangers of smoking and find help to quit.

Alcohol: A baby can be exposed to the same level of alcohol as the mother during pregnancy. There is no known safe amount of alcohol use during pregnancy.

Marijuana Use: Marijuana use during pregnancy can be harmful to your baby’s health. The chemicals in marijuana (in particular, tetrahydrocannabinol or THC) pass through your system to your baby and can harm your baby’s development.

Vaccinations: Did you know a baby gets disease immunity (protection) from mom during pregnancy? This immunity can protect baby from some diseases during the first few months of life, but immunity decreases over time.

Infections: You won’t always know if you have an infection—sometimes you won’t even feel sick. Learn how to help prevent infections that could harm your developing baby.

HIV: If you are pregnant or are thinking about becoming pregnant, get a test for HIV as soon as possible and encourage your partner to get tested as well. If you have HIV and you are pregnant, there is a lot you can do to keep yourself healthy and not give HIV to your baby.

West Nile Virus: Take steps to reduce your risk for West Nile virus and other mosquito-borne infections.

Diabetes: Poor control of diabetes during pregnancy increases the chance for birth defects and other problems for your baby. It can cause serious complications for you, too.

High Blood Pressure: Existing high blood pressure can increase your risk of problems during pregnancy.

Medications: Taking certain medications during pregnancy might cause serious birth defects for your baby. Talk to your doctor or pharmacist about any medications you are taking. These include prescription and over-the-counter medications and dietary or herbal supplements.

Depression: Depression is common and treatable. If you think you have depression, seek treatment from your health care provider as soon as possible.

Emergencies: Did you know that when you’re pregnant you might need additional supplies or need to protect yourself during an emergency? Public health emergencies can affect access to medical and social services, increase stress, intensify physical work, and expand caregiving duties.

Environmental and Workplace Exposures: There are some common environmental and workplace hazards that could be harmful to pregnant or breastfeeding people, or to household members when carried home on clothes, skin, and shoes. Talk to your doctor or your employer about what you are exposed to at work.

• The Pediatric Environmental Health Specialty Units (PEHSUs) are a direct link to medical and health professionals. Because environmental factors can impact health of children and reproductive age adults, the PEHSU network has experts in pediatrics, allergy/immunology, neurodevelopment, toxicology, occupational and environmental medicine, nursing, reproductive health and other specialized areas. There are regional specialists across the country to answer your questions.
• The Agency for Toxic Substances and Disease Registry (ATSDR) has many fact sheets about toxic substances (e.g, lead, benzene) if you have concerns about toxic exposures.

Radiation: If you think you might have been exposed to radiation, talk with your doctor.

How Do Genetics and Family History Affect Pregnancy?

Genetics: Understanding genetic factors and genetic disorders is important for learning more about preventing birth defects, developmental disabilities, and other unique conditions in children.

• Family History: Family members share their genes and their environment, lifestyles, and habits. A family history can help identify possible disease risks for you and your baby.

• Genetic Counselor: Your doctor might suggest that you see a genetic counselor if you have a family history of a genetic condition or have had several miscarriages or infant deaths. Top of Page

What Are Other Concerns During Pregnancy?

Bleeding and Clotting Disorders: Bleeding and clotting disorders can cause serious problems during pregnancy, including miscarriage. If you have a bleeding or clotting disorder, talk with your doctor.

Disaster Safety for Expecting and New Parents: Learn general tips to get prepared before a disaster and what to do in case of a disaster to help keep you and your family safe and healthy.

Premature Birth: Important growth and development occur throughout pregnancy – all the way through the final months and weeks. Babies born three or more weeks earlier than their due date have greater risk of serious disability or even death. Learn the warning signs and how to prevent a premature birth.

Travel: If you are planning a trip within the country or internationally, talk to your doctor first. Travel might cause problems during pregnancy. Also, find out about the quality of medical care at your destination and during transit.

Violence and Pregnancy: Violence can lead to injury and death among women in any stage of life, including during pregnancy. Learn more about violence against women, and find out where to get help. 

What Are Other Things to Think About Before the Baby Arrives?

Breastfeeding: You and your baby gain many benefits from breastfeeding. Breast milk is easy to digest and has antibodies that can protect your baby from bacterial and viral infections.

Jaundice and Kernicterus: Any baby can get jaundice. Severe jaundice that is not treated can cause brain damage. Your baby should be checked for jaundice in the hospital and again within 48 hours after leaving the hospital. If you think your baby has jaundice, call and visit your baby’s doctor right away.

Newborn Screening: Within 48 hours of your baby’s birth, a sample of blood is taken from a “heel stick,” and the blood is tested for treatable diseases. More than 98% of all children born in the United States are tested for these disorders.

Sudden Infant Death Syndrome (SIDS): Learn what parents and caregivers can do to help babies sleep safely and reduce the risk of sleep-related infant deaths, including SIDS.

Child Safety Seats: Motor vehicle injuries are a leading cause of death among children in the United States. But many of these deaths can be prevented. Always buckling children in age- and size-appropriate car seats, booster seats, and seat belts reduces serious and fatal injuries by up to 80%.