Lupus: symptoms, causes and which doctor to see

For lupus you can first see: Internal Medicine or Dermatology or Rheumatology. In large hospitals, the Rheumatology unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: a butterfly-shaped redness on the cheeks and bridge of the nose; rashes that get worse with sun exposure; joint pain and swelling; unexplained fever and extreme tiredness; painless mouth ulcers and hair loss; fingers turning white and blue in the cold; swollen feet and foamy urine (kidney involvement). Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

Do not stop the treatment your doctor prescribed on your own; stopping suddenly can cause a flare.

The most common causes: the immune system producing antibodies against its own tissues; genetic susceptibility; hormonal factors (much more common in women); triggers such as sunlight, infections and certain medicines. Only a doctor’s examination can determine the exact cause.

Lupus is chronic, with flares and quiet periods. With regular treatment and follow-up most patients lead a normal life; the aim is to prevent organ damage.

It is more common in: women aged 15–45 most often (about 9 times more common than in men); people with lupus or another autoimmune disease in the family.

Along with symptoms and examination, antibody tests such as ANA and anti-dsDNA, a full blood count, complement levels and a urine test are evaluated. A positive ANA alone does not mean lupus; it can also be found in healthy people.

The disease cannot be prevented; sun protection, stopping smoking and regular check-ups reduce flares.

You can see internal medicine, or dermatology if skin findings dominate; diagnosis and follow-up are done by rheumatology. Nephrology joins in if the kidneys are involved.

No, a positive ANA does not always mean lupus. It can be mildly positive in healthy people, older people and other diseases; your doctor interprets it together with your symptoms.

Yes, most can have a healthy pregnancy. Pregnancy should be planned for a quiet period of the disease and followed by both a rheumatologist and an obstetrician.

If the answer to any of these questions is yes, call 112 without delay: “Is there chest pain that worsens when breathing in, or breathlessness?” “Is there a seizure, confusion or sudden weakness?” “Has urine output dropped sharply, or is there swelling all over the body?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: if a facial rash that worsens in the sun comes with joint pain; for long-lasting unexplained fever and tiredness; if foamy urine or swollen feet have started.