Causes and Risk Factors
The exact cause is unknown. Lupus appears to develop when a genetic predisposition meets environmental triggers such as sunlight, infections, and certain medications. Hormones likely play a role, which helps explain why about nine out of ten adults with lupus are women. Lupus is not contagious and is not caused by anything a patient did; flares, however, can be set off by sun exposure, infections, physical or emotional stress, and stopping medications abruptly.Symptoms
Lupus is famously variable — no two cases look quite alike — but common features include:- Joint pain and swelling: Aching, stiff joints resembling inflammatory arthritis, usually without the permanent joint damage of rheumatoid arthritis.
- Butterfly rash: A red rash across the cheeks and bridge of the nose, often after sun exposure.
- Photosensitivity: Sunlight can trigger both rashes and systemic flares — an everyday consideration under the strong Florida sun, where daily sunscreen and protective clothing are part of treatment.
- Fatigue and fever: Profound tiredness and low-grade fevers accompany active disease.
- Blood abnormalities: Lupus can cause anemia, low white cells, and thrombocytopenia (low platelets).
- Kidney involvement: Lupus nephritis may cause swelling, foamy urine, and high blood pressure, and is a major driver of long-term outcomes.
- Other features: Fingers that blanch in the cold (Raynaud phenomenon), mouth ulcers, hair thinning, and chest pain with deep breaths from inflammation of the heart or lung linings.
Diagnosis
No single test proves lupus. Physicians combine the clinical picture with blood tests — nearly everyone with lupus has a positive antinuclear antibody (ANA), and more specific antibodies such as anti-double-stranded DNA support the diagnosis — plus blood counts, kidney function tests, and urine studies to look for protein. Because early symptoms overlap with many other illnesses, diagnosis often takes time and repeated evaluation. Once lupus is diagnosed, many of the same tests are repeated periodically to track disease activity.Treatment
Treatment is tailored to which organs are involved and how active the disease is:- Hydroxychloroquine: Recommended for nearly all patients — it reduces flares, protects organs, and improves long-term survival.
- Corticosteroids: Prednisone controls flares quickly; the goal is always the lowest dose for the shortest time.
- Immunosuppressants: Methotrexate and similar medicines control joint and skin disease and allow lower steroid doses; stronger agents are used for kidney involvement.
- Sun protection and lifestyle: Broad-spectrum sunscreen, not smoking, regular exercise, and keeping vaccinations current all reduce complications.
- Regular monitoring: Periodic blood and urine testing catches kidney inflammation early, when it is most treatable.