Lupus: Consequences of the Disease and Joint Involvement

Systemic lupus erythematosus is a long-term autoimmune disease in which the immune system attacks the body's own healthy tissues and causes inflammation. The disease can be mild or severe and can affect different organs, so its consequences look different in different people. Below is a reference overview of what is known about joint and other organ involvement in lupus.

What systemic lupus erythematosus is

It is a chronic autoimmune disease: the body's defense system mistakenly attacks healthy cells and tissues, causing inflammation. Systemic lupus erythematosus (SLE) is the most common type; in addition to it, cutaneous, drug-induced, and neonatal forms are distinguished. The cause is unknown; genetics, viral infections, sunlight, certain medications, and smoking are being studied. Women are affected significantly more often than men. Symptoms come in waves: flares alternate with periods of remission.

Consequences and complications of lupus

Inflammation in lupus can damage various organs. Lupus nephritis (kidney involvement), inflammation of the heart and its membranes, inflammation of blood vessels, blood clots, and pleuritis with pain on breathing have been described. Some people have a higher risk of coronary heart disease and atherosclerosis. Severe inflammation of the heart, lungs, brain, or kidneys can lead to life-threatening damage. Lupus can complicate the course of pregnancy, so plans for pregnancy are discussed with a doctor in advance.

How lupus affects the joints

Most patients suffer from joint pain; the small joints of the hands and wrists are most often involved. Arthralgias occur, less often polyarthritis with symmetrical joint involvement, as well as diffuse muscle pain. Unlike rheumatoid arthritis, arthropathy in SLE does not destroy bone tissue, but in 20% of patients joint deformities become irreversible. In men, a typical onset is sacroiliitis.

• joint pain and morning stiffness
• symmetrical inflammation of the small joints of the hands
• muscle pain without bone destruction
• possible persistent joint deformities

How lupus arthritis differs from other arthritides

The key difference is its non-erosive nature: lupus arthritis does not erode bone the way rheumatoid arthritis does. At the same time, deformities are still possible and in some patients remain permanently. Joint manifestations usually occur together with other signs of lupus — rash, fatigue, skin changes. It is by the combination of symptoms and test results that a doctor distinguishes lupus from similar diseases.

Which organs may be involved

In addition to the joints, involvement of the skin (butterfly rash, discoid lesions, hair loss), kidneys, heart and blood vessels, lungs, blood (anemia, decreased platelets and white blood cells), eyes (dryness, conjunctivitis), and the nervous system — from headaches to cognitive and anxiety disorders — has been described. The American College of Rheumatology describes 19 neuropsychiatric syndromes in SLE.

When to see a rheumatologist

The reason may be frequent or persistent symptoms of lupus: joint pain, rash after sun exposure, persistent fatigue. The diagnosis is made based on a combination of typical symptoms and tests (antinuclear antibodies, complete blood count, urine tests, skin or kidney biopsy); sometimes examinations of the heart, kidneys, and other organs are needed. Follow-up with a rheumatologist and regular check-ups help to detect organ involvement in time.

Having lupus alone is not a reason to call an ambulance. Call 103 or 112 if signs of a life-threatening condition appear: severe chest pain, marked shortness of breath, confusion, seizures, signs of severe kidney or heart damage.

This material is for reference and does not replace a doctor's consultation: ask your rheumatologist your questions about the joints, tests, and follow-up — the decision remains with you and your doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer