General features

Fatigue:

The most common feature of lupus is fatigue. It is a major symptom in some patients, and can be extremely distressing. The cause of this fatigue is still poorly understood, but generally, energy levels seem to improve once the disease is brought under control.


Skin Rashes:

These can affect any part of the body, the most well-known being the so called “butterfly rash” over the cheeks and the bridge of the nose. In many patients the rash is made worse by exposure to ultra-violet light e.g. sunlight.


Hair Loss:

Hair loss is an important feature of lupus and is often the first sign of a disease flare. In the majority of patients the hair grows back totally once the disease is brought under control.


Joint Aches and Pains:

Flu like symptoms are common in lupus patients and are a major feature of the disease. Sometimes joint pains can be severe, mimicking early rheumatoid arthritis but normally the joints are not damaged and this clearly differentiates lupus from rheumatoid arthritis.


Dry (scratchy) eyes:

Many patients with lupus also have “Sjögren’s syndrome” with poor tear secretion. This results in irritation of the eyes and in some patients quite marked dryness. This is usually helped by artificial tears (e.g. hypromellose eye-drops).


Inflammation of Tissues covering internal organs:

The thin “sausage-skin” covering internal organs such as the heart (pericardium) and lungs (pleura) can be inflamed leading to painful symptoms such as pleurisy.


Depression:

This is a major feature of lupus and very common indeed. It often requires both treatment of the lupus itself as well as the depression.


Kidney Problems:

The kidney is the “silent” organ and often patients do not know that the kidney is involved; it is common practice in our unit to teach patients to test their own urine (using “dip sticks” or “albustix sticks”). Urine testing is essential in lupus patients for the early detection of kidney involvement, for which treatment must be prompt.