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Some people who have
lupus (systemic lupus erythematosus, or SLE) develop
complications with internal organs, such as the kidney, heart or lungs.
Most people with lupus are able to
continue their usual daily activities. You may find that you need to cut back
on your activity level, get help with child care, or change the way you work
because of fatigue, joint pain, or other symptoms. You may find that you have
to take time off from daily activities entirely.
Most people with
lupus can expect to live a normal or near-normal life span. This depends on how
severe your disease is, whether it affects vital organs (such as the kidneys),
and how severely these organs are affected.
Lupus usually does not
cause joint damage or deformity, which may happen in people who have
rheumatoid arthritis, another
Medicines used to
treat moderate to severe lupus have side effects. It can be difficult to tell
what problems are part of the natural course of the disease and what problems
are due to effects of medicines used to control the disease.
the past, lupus was not well understood. People who had lupus died younger,
usually of problems with vital organs. Now that the disease can be treated more
successfully, life expectancy with lupus has increased significantly.
Hormones such as
prolactin are sometimes used for hormone therapy, birth control, and as part of fertility treatments. Studies do not agree on whether taking hormones increases the risk for lupus or
for lupus symptom flares. If you are thinking about taking hormones, talk to your doctor about the risks and benefits of this treatment.
Lupus doesn't typically affect a woman's ability
to conceive. But if you are having a lupus flare or are taking
corticosteroid medicines, you may have irregular menstrual cycles, making it
difficult to plan a pregnancy.
It is not clear whether women have
more lupus flares during pregnancy. But there does seem to be an increased risk
to the developing fetus.1 The risks are decreased if
the woman avoids becoming pregnant during a period of active lupus activity. So
it's a good idea for women who have lupus to use effective birth control when lupus
is active.2 If you plan to have a baby or are already
pregnant, it is very important that you and your doctor discuss
how lupus may affect your pregnancy.
affect many people who have lupus.
These problems usually don't cause any symptoms, but some people may
notice swelling in their legs or ankles (due to fluid retention) that they have
not had in the past. The first sign of kidney problems is often abnormal
urinalysis findings, such as protein, blood, or white
blood cells in the urine or granular or red cell casts (clumps of red blood
cells or kidney cells).
In a few cases, kidney
problems are so severe that the kidneys stop working properly or fail
completely. Depending on how severe kidney damage is, treatment can include
strong medicines to control the lupus,
kidney dialysis, or a kidney transplant.
Heart problems caused by lupus
About 1 out of 3 people who have lupus develop
inflammation of the tissue around the lungs.1
Sometimes this causes no symptoms. At other times it causes painful
breathing, coughing, or chest pain that is worse with a deep breath (pleurisy). Many people with lupus have chest pain when
they breathe. When this pain is not caused by pleurisy, it is commonly caused
by inflammation of the chest muscle, cartilage, or ligaments, or of the joints
that connect the ribs to the breastbone (costochondral joints). In these cases,
the lungs may not be affected.
Less common lung problems
with lupus include fever, cough, and inflammation of the lung tissue
(acute lupus pneumonitis). Some people with lupus produce an antibody that
causes their blood to clot more easily (antiphospholipid antibody). These people may be at risk for clots
in the lung (pulmonary emboli). An unusual
complication is the buildup of fluid in the lungs (pulmonary edema), caused by heart or kidney problems.
Blood-related problems are
common in people who have lupus, but they do not always cause detectable
symptoms. These problems, which in a few cases are severe and even
Neurological (nervous system) problems associated with lupus
The physical and emotional
stress of coping with a chronic illness can make it difficult to maintain good
Problems in the digestive
system are not common with lupus but may include:
Crow MK (2012). Systemic lupus erythematosus. In L Goldman, A Schafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 1697–1705. Philadelphia: Saunders.
Wofsy D (2005). Therapy of systemic lupus
erythematosus. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2,
pp. 1561–1574. Philadelphia: Lippincott Williams and Wilkins.
Roman MJ, Salmon JE (2007). Cardiovascular
manifestations of rheumatic diseases. Circulation,
May 10, 2012
Anne C. Poinier, MD - Internal Medicine & Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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