Clinical Manifestations Clinical Manifestations

Neuropsychiatric

Manifestations include psychosis, depression, anxiety, seizure, stroke and neuropathy. It is unclear whether they indicate CNS involvement or are secondary to the distress of living with a chronic illness.

Hematologic

Manifestations include normochromic, normocytic, low iron concentration, or hemolytic anemia, leukopenia as well as thrombocytopenia.

Renal

Manifestations include an increase in serum creatinine and proteinuria.

Progression to endstage kidney disease is a major cause of morbidity and mortality, but the course of the disease is variable and many Lupus nephritis patients do very well.

Musculoskeletal

Arthralgia and arthritis are frequently the chief complaint upon initial presentation.

Arthritis presents as joint stiffness, pain and inflammation, affects small and large joints, its pattern is usually recurrent and its duration is short.

Pulmonary

Manifestations include cough, rales, tachypnea, dyspnea, pneumonitis and pleural effusion.

Pulmonary hypertension has also been reported and people with it usually have a poor prognosis.

Cardiac

Manifestations range from hypertension to pericarditis, myocarditis, heart murmur and coronary artery disease. The use of corticosteroids and underlying renal disease may be contributing factors.

Gastrointestinal

Manifestations include dyspepsia, abdominal pain, difficulty swallowing as well as oral or nasopharyngeal ulceration.

Cutaneous

A Malar rash, also known as butterfly rash, is seen in half of the patients.

Photosensitivity is common.

Manifestations include discoid lesions, Raynaud’s phenomenon, alopecia and vasculitis.

In addition to the above, patients with Lupus may experience nonspecific signs and symptoms such as fatigue, fever, anorexia and weight loss, which are seen frequently in patients with an active disease.