If you have a fever, extreme fatigue, or inflammation in your feet or toes, you may believe you have a COVID-19 infection. Similarly, if you experience chest pain when taking a deep breath, you may think you are having a heart attack.
But, if a doctor rules out COVID-19 or a heart attack, the symptoms may be signs of lupus, an autoimmune disease. With any autoimmune disorder, the immune system attacks healthy tissues and cells because it mistakes them as foreign invaders in the body.
Lupus shares symptoms with other medical conditions, such as coronavirus disease, pneumonia, heart attack, and mood disorders, such as anxiety and depression. So, lupus may not be the first medical condition that comes to mind.
Unlike COVID-19, which is an infectious disease, lupus is not contagious. Lupus is a chronic disease that people live with for the rest of their lives. There will be “flare-ups” when symptoms worsen, but there will also be times when the disease is in remission. This is what makes lupus tricky to diagnose, according to Lauren Metelski, senior manager of the Health Education Specialists at the Lupus Foundation of America.
“It can be a moving target,” Lauren Metelski says. “You might have a few bad weeks and schedule a doctor’s appointment, then the symptoms get better by the time you go in.”
An estimated 1.5 million Americans, and at least 5 million people worldwide, have a form of lupus, according to the Lupus Foundation of America. Most people develop the disease between the ages of 15-44, and an estimated 16,000 new cases of lupus are reported each year.
The foundation says that anyone can develop the disease, but statistics show that 90 percent of people with lupus are women. Other groups at a higher risk for developing lupus include:
- Certain racial or ethnic groups, including African American, Asian American, Pacific Islander, Hispanic/Latino, and Native American, are at higher risk for the disease
- People with a family member with lupus or another autoimmune disease
Health professionals advise getting regular check-ups since inflammation caused by lupus can affect the skin, joints, blood cells, tissues, kidneys, heart, and other internal organs. For instance, the risk of heart disease, strokes, and heart attacks are two times higher than normal for people with lupus, according to the Mayo Clinic.
Symptoms and Signs of Lupus
Diagnosing lupus is not easy because the disease has a wide range of signs and symptoms. What’s more, symptoms can be mild or severe or temporary or permanent. Some of the most commonly reported symptoms and signs include:
- Abnormal blood clotting
- Butterfly-shaped rash that appears on the face or on skin that is exposed to the sun
- Chest pain upon taking a deep breath
- Dry eyes and mouth
- Extreme fatigue
- Gastrointestinal issues
- Hair loss
- Joint pain
- Kidney problems
- Muscle aches
- Sore on the nose, in the scalp, or in the mouth
- Swollen feet, hands, and leg
- Unexplained fever
Besides looking for symptoms, doctors run blood and urine tests to help diagnose lupus and determine what parts of the body the disease is affecting. For instance, the tests can determine how well the liver and kidneys are functioning because lupus affects internal organs. Also, a chest x-ray and an echocardiogram can determine whether lupus is affecting the heart or lungs.
There is no known cure for lupus, but the disease can be managed. If you have been diagnosed with lupus, your medical team will advise you of steps to take and will prescribe certain drugs that target the disease. Some medications used to treat lupus include:
- Anti-malarial drugs. These drugs were initially used to prevent and treat malaria but are now prescribed for other health conditions, including lupus. These drugs are known to reduce joint pain, rashes, inflammation, and the number and intensity of other lupus symptoms.
- BLyS-specific inhibitors. These drugs limit the number of abnormal B cells that grow and attack different parts of the body. Normal B cells produce immune cells that create antibodies to fight lupus.
- Corticosteroids. Whether in the form of shots, pills, or creams, corticosteroids help reduce physical pain.
- Immunosuppressant drugs. These types of drugs suppress the immune system to make it less likely to attack the body. Immunosuppressant drugs are used when lupus affects major organs and other treatments do not work. These drugs can cause serious side effects because they lower the body’s ability to fight off infections.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Non-prescription NSAIDs, such as ibuprofen and naproxen, help reduce chronic pain and swelling in joints and muscles.
In addition to medication, lifestyle changes are helpful in managing lupus:
- Avoid sun exposure as much as possible. When spending time outdoors, wear protective clothing. Use sunscreen with a sun protection factor (SPF) of 50 or higher and apply it at least 20 minutes before going out in the sun.
- Ask your doctor if you should take a vitamin D supplement. Studies have found that low levels of vitamin D are associated with an increase in lupus flares.
- Maintain a healthy lifestyle. Exercise regularly, eat a diet rich in vegetables, fruits, and whole grains, and do not smoke. Reduce and manage stress as much as possible.
- Make adjustments to your job. Depending on the number and type of symptoms you have, you may benefit from changes in your job. For instance, getting an ergonomic chair, asking for a more flexible schedule, such as reduced hours or working from home, or exploring the possibility of applying for disability benefits from your employer or from the Social Security Administration.
- Make adjustments to your school schedule. The demands of school can bring on stress. So, it is advisable to talk with your professor, principal, or academic advisor about having lupus, and discuss any accommodations that may be necessary. Do not carry a heavy course schedule, try to leave time for relaxation.
One of the most important ways to manage lupus is to have support from family, friends, and others who have lupus and understand the challenges of the disease.
Living with lupus is possible with help from your medical care team that will monitor and treat the disease. It may not always be easy, but you can still live your life and do the things that you enjoy.