Lupus Complications: Everything You Need To Know

Lupus is a chronic, multisystem, inflammatory autoimmune disease. The exact cause of lupus remains unknown. However, certain risk factors can increase a person's likelihood of developing the disease.

The most common form of lupus is systemic lupus erythematosus (SLE), which can lead to inflammation within various organs and systems of the body, such as the heart, skin, brain, and more. This can lead to the development of fatigue, rashes, fever, chest pain, and kidney disease, among other symptoms.

This article discusses the various complications that can develop due to undiagnosed or poorly managed lupus.

Symptoms

Lupus can involve multiple organs and tissues within the body. This can lead to the development of general, vague, and seemingly unrelated symptoms.

Common symptoms of lupus include:

• Fatigue
• Hair loss
• Butterfly-shaped rash on the face (known as a malar rash) or other rashes
• Joint and muscle pain
• Chest pain with deep breathing
• Sensitivity to light
• Sores in the mouth or nose

Some symptoms may be so vague that they go ignored or undiagnosed for years.

When symptoms progress, people can develop:

• Anemia (lack of healthy red blood cells)
• Kidney dysfunction
• Seizures
• Heart inflammation
• Eye disease
• Blood-clotting problems
  

Risk Factors

While no definitive cause for lupus has been determined to date, both genetic and environmental factors have been shown to increase a person's likelihood of developing the disease. These risk factors include:

• Female gender
• Ages 15 to 44
• Non-White population
• Family history
• Certain medications can lead to drug-induced lupus
• Immune stimulation from infections
• Cigarette smoking
  
• Crystalline silica exposure

Complications

Since lupus is such a complex disease and often presents with vague symptoms, it may take some time before the proper diagnosis is made or confirmed.

Prolonged, undiagnosed lupus, or even poorly managed lupus, can lead to the development of one or many complications. These can affect various parts of the body ranging from the heart, the kidneys, the nervous system, and everywhere in between.

Blood

Lupus can affect a person's blood in various ways.

The most common blood complication is anemia, a condition characterized by low red blood cell (RBC) count. Anemia can lead to symptoms such as fatigue, headache, and shortness of breath.

In addition to low RBCs, lupus can also lead to a low white blood cell (WBC) count, known as leukopenia.

White blood cells play an important role in the body's ability to fight off infection, so a low WBC count can indicate a weakened immune system. This makes people more vulnerable to disease and infection.

In addition to low WBCs, platelets may also be affected by lupus, leading to clotting abnormalities known as thrombosis. It also increases the risk of bleeding and/or bruising.

Another serious blood complication of lupus is the development of lupus vasculitis (LV). In LV, there is inflammation within small- or medium-sized vessels of the skin, brain, heart, gut, or any other place in the body.

The organ system most affected by vasculitis is the skin. It can lead to tiny pinpoint-like bruising, ulcers, or sores. Depending on which area of the body is affected by LV, symptoms can range from skin rashes to seizures and even vision loss.

Lungs

Heart and lung involvement in lupus is quite common and can lead to some serious long-term complications. Lupus affecting the lungs and pulmonary system can result in the development of:

• Pleuritis (inflammation of the lining covering the lungs)
• Pneumonitis (inflammation within lung tissue)
• Interstitial lung disease (scarring of the lungs due to chronic inflammation)
• Pulmonary embolism (blood clot in the lung)
• Pulmonary hypertension (increased blood pressure in the lung arteries)

All of these complications can lead to symptoms such as:

• Fever
• Cough
• Pain when breathing deeply
• Shortness of breath

Adequate treatment of systemic inflammation can help reduce the severity of symptoms, along with a reduction of permanent lung damage.

Heart

Having lupus increases a person's risk of developing heart disease, including coronary artery disease and high blood pressure. Since lupus is an inflammatory disease, inflammation can be seen throughout the heart in complications, such as:

• Myocarditis (inflammation of the heart muscle)
• Endocarditis (inflammation of the inner lining of the heart's chambers and valves)
• Pericarditis (inflammation of the sac surrounding the heart)

Common symptoms of cardiac lupus complications include:

• Chest pain or pressure
• Chest palpitations
• Shortness of breath
• Fever
• Night sweats
• Fainting or dizziness

Kidneys

The kidneys play many important roles in the body. They are responsible for:

• Filtering toxins
• Removing excess fluid
• Regulating red blood cell production
• Balancing minerals
• Regulating blood pressure

Anything that can potentially damage or harm the kidneys can be detrimental to a person's proper bodily function.

One of the most common yet severe complications of lupus is the development of lupus nephritis.

Lupus nephritis occurs in nearly 60% of people with lupus. It develops when the body's own immune system mistakes normal kidney tissue as a foreign invader. This leads to an immune and inflammatory response targeting the kidneys. The subsequent immune response can lead to severe or permanent damage to the kidneys.

While early lupus nephritis may not cause any symptoms, progressive disease can lead to:

• Swollen ankles
• Weight gain
• High blood pressure
• Decreased kidney function, including decreased urine output

Nervous System

Lupus can affect the central, peripheral, and/or autonomic nervous systems.

When the central nervous system (brain or spinal cord) is involved, symptoms can include brain fog, headaches, seizures, or even stroke.

The peripheral nervous system (PNS) is responsible for controlling the nerves that cause muscle contraction, as well as those that communicate to the brain how the body is feeling. Lupus affecting the PNS can lead to:

• Neuropathy (damaged or dysfunctional nerves)
• Tingling or numb sensations throughout the body
• Vision loss
• Dizziness
• Facial pain
• Ear ringing

The autonomic nervous system (ANS) regulates important body functions, such as heart rate, breathing, and blood flow. Lupus complications affecting the ANS can lead to symptoms such as:

• Erratic heartbeat and breathing
• Palpitations
• Vomiting and diarrhea

Mental Health

Research has found a link between neurological lupus and a person's mental health.

Neuropsychiatric SLE (NPSLE) refers to neurological and psychiatric symptoms directly related to SLE. Symptoms can include:

• Headache
• Anxiety
• Depression
• Cognitive dysfunction
• Brain fog
• Seizures
• In some cases, psychosis
  

Summary

Lupus is a complex, multisystem autoimmune disease. It is characterized by chronic inflammation throughout the body, which can lead to some long-term and serious complications.

Lupus complications can occur within the blood, heart, lungs, kidneys, and central nervous system. It can also lead to mental health disturbances.

A Word From Verywell

At times, living with lupus and its associated complications can be difficult. However, due in large part to advancements in modern medicine and an increase in community support, people with lupus are able to live full and manageable lives.

If you are living with lupus, be sure to have open and honest conversations with your healthcare provider to ensure you are receiving the best treatment for your disease. Well-controlled lupus can decrease the possibility of serious complications.