Serious Conditions Associated with Lupus

Although lupus can be well controlled in many people, serious medical conditions caused by or associated with the disease can still occur. It is important that you know about these conditions and how they may make you feel so that you can call your doctor right away. The sooner a problem is detected and evaluated, the sooner it can be treated to prevent or reduce damage to your body’s organs.

Kidney disease: Many people with lupus develop some form of mild kidney disease. Others, however, develop kidney disease serious enough to lead to kidney failure. Warning signs include:

• swelling around your ankles, hands, and eyes;
• increased fatigue or tiredness, especially if you have not altered your rest and activity patterns; and
• increased need to urinate at night.

Pericarditis: Pericarditis is an inflammation of the thin sac that surrounds the heart. Warning signs include:

• chest pain,
• shortness of breath, and
• new or higher-than-usual fever.

Myocarditis: Myocarditis is an inflammation of the heart muscle. Warning signs include:

• chest pain,
• shortness of breath, and
• new or higher-than-usual fever.

Atherosclerosis: This is a condition in which fatty deposits build up on the inside of arteries. These deposits can reduce or block blood flow. A blockage or reduced blood flow through an artery that supplies the heart can cause a heart attack to occur. Warning signs include:

• burning, choking, squeezing, or pressing chest pain felt in the center of the chest that may radiate to the left shoulder and arm (anginal pain); it can last up to 5 minutes and will become much less intense or go away completely if you rest;
• crushing, prolonged chest pain that is not relieved by rest;
• shortness of breath;
• unrelieved indigestion; and
• a weak or faint feeling.

Pleuritis: Pleuritis is an inflammation of the lining of the lung. Warning signs include:

• shortness of breath, and
• chest pain, especially when taking a deep breath.

Central nervous system (CNS) disease: CNS disease covers a variety of problems that may or may not be related to lupus. Problems can include seizures, memory loss, headache, confusion, hearing and visual changes, muscle weakness, depression, and emotional disturbances. Because many of these problems can be related to use of medications or indicate other conditions, it is often difficult to make a definite diagnosis of CNS disease. Warning signs include:

• severe or chronic headaches;
• seizures;
• periods of forgetfulness, restlessness, or confusion;
• new or increased hearing and vision problems;
• bizarre or erratic changes in behavior;
• mood swings; and
• signs of a stroke, including weakness or numbness in the arms, legs, face, or down one side of the body; a change in speech; confusion; or severe headaches.

Depression: With depression, people may feel helpless, hopeless, or overwhelmed. They may find it difficult to get through the day. Depression can occur as a result of lupus or be caused by the drugs used to treat it, especially cortico-steroids. Warning signs include:

• depressed mood;
• significant weight loss or gain;
• trouble sleeping or sleeping too much;
• extreme tiredness and lack of energy;
• decreased concentration or an inability to make a decision;
• feelings of being overwhelmed and unable to carry out simple tasks, such as personal hygiene, housework, or childcare;
• feelings of hopelessness about various aspects of life;
• unusual anger or irritability; and
• recurrent thoughts of death and suicide.

Osteonecrosis: This is a condition that usually affects the hip joint, but may occur in other joints such as the knees, ankles, or shoulders. Blood supply to the hip is reduced and, over time, leads to severe degenerative arthritis. Osteonecrosis is considered to be a side effect of corticosteroid therapy and not a manifestation of SLE itself. Warning signs include:

• sharp pain in the groin or buttocks that may radiate down the back of the leg,
• decreased exercise tolerance,
• stiffness of the hips, and
• increased pain and difficulty in walking after exercise.

Pancreatitis: In pancreatitis, the pancreas (an organ involved in digestion and in producing hormones that regulate blood sugar levels) becomes inflamed. It is a very serious problem that must be treated immediately. Warning signs include:

• sharp, intense pain at the level of the belly button that radiates around to the back;
• nausea and vomiting; and
• new or higher-than-usual fever.

Acute abdomen: This is a condition that describes the sudden onset of abdominal pain. A variety of serious problems can cause this condition. You should see your doctor immediately if you develop acute abdomen. Warning signs include:

• abdominal pain that may be severe and radiate throughout the abdominal area;
• nausea, vomiting, or loss of appetite;
• change in usual bowel movements; and
• vomiting blood or blood in the stool.

Vision problems: Changes in vision can be a result of lupus or because of the corticosteroids and antimalarials used to treat lupus. Problems can include inflammation of the eye, glaucoma, cataracts, general changes in vision, and blocked tear ducts. On very rare occasions, blindness can result. Warning signs include:

• development of a rash over the eyelids;
• mucus discharge from the eye;
• blurred vision;
• sensitivity to light;
• headaches;
• a sore, red eye;
• lack of tears, and eyes that hurt and are dry; and
• episodes of flashing lights and partial blindness.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, January 1999