A variety of complications can arise from lupus, causing an array of additional symptoms. Some of these complications include the following conditions.
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Lupus nephritis, inflammation of the kidneys, is one of the most common complications of lupus. (13) People with lupus nephritis are at a higher risk of developing end-stage renal disease, requiring dialysis or a transplant, says Kaplan. Symptoms of lupus nephritis include high blood pressure; swelling of the hands, arms, feet, legs, and area around the eyes; and changes in urination, such as blood or foam in the urine, needing to go to the bathroom more frequently at night, or pain or trouble urinating.
Lupus can cause problems with the blood, too, including anemia, or low red blood cell count. Anemia can cause symptoms such as weakness and fatigue. (14) Thrombocytopenia is another blood disorder that may develop, resulting in lower platelet counts. (Platelets are the cell fragments that help the blood clot.) Symptoms of thrombocytopenia can include bruising easily, nosebleeds, and petechiae, when the blood appears as red pinpoints under the skin. (15)
Atherosclerosis, or clogging of the arteries, can develop in people with lupus. This can cause chest pain and raise the risk of stroke, heart attack, and heart failure. People with lupus nephritis may be at a greater risk of developing atherosclerosis, according to a study published in PLoS One. (16)
Pericarditis, or inflammation of the sac that surrounds the heart, can be an early complication of lupus, says Kramer. Symptoms include a sharp pain in the chest and shortness of breath. Chronic inflammation can damage the heart tissue, making it more difficult for the heart to pump blood. (17)
Inflammation of the heart, called myocarditis, can cause chest pain, says Francis Luk, MD, an assistant professor of rheumatology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Other symptoms include unexplained rapid or irregular heartbeat, and heart failure is possible.
Pleuritis and Pleural Effusion
Inflammation of the lining surrounding the lungs, or pleuritis, can occur in people with lupus. This can cause symptoms such as chest pain and shortness of breath, says Dr. Luk. The pain can worsen when taking a deep breath, sneezing, coughing, or laughing. (18) Pleural effusion, or fluid around the heart and lungs, may also develop and can cause shortness of breath or chest pain, says Caricchio.
Central Nervous System Inflammation
Inflammation of the central nervous system can cause confusion, seizures, and psychosis, says Luk. It can contribute to an increased risk of depression, headache, and stroke, as well as problems with vision in people with lupus. (19)
Miscarriage and Preterm Labor
Women with lupus have a higher risk of miscarriage and preterm labor, says Kaplan. Pregnant women with lupus also have a higher risk of preeclampsia — a serious condition causing increases in blood pressure and protein in the urine — and signs that the kidneys and liver may not be functioning well. (20) If you have lupus and do get pregnant (or if you have lupus and are trying to get pregnant), see a high-risk maternal-fetal medicine specialist who has expertise in how to best handle such pregnancies. Be sure to talk with your rheumatologist well in advance of trying to get pregnant.