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What to know about rare symptoms of lupus

Some less common lupus symptoms may include angina, stroke, and blood issues. Lupus can cause inflammation and pain throughout the body, so symptoms may differ from person to person.

Lupus is a chronic autoimmune disease in which the immune system mistakenly attacks healthy body cells and tissues.

Doctors rely on the manifestation of symptoms over time to diagnose lupus. Alongside lab tests, they will look for signs of autoimmune dysfunction. Common symptoms may include joint pain and swelling, skin rashes, and fatigue.

However, recognizing and reporting the less common symptoms of lupus can help doctors make an accurate diagnosis.

This article lists the less common symptoms of lupus, provides information on how doctors diagnose this disease and advises when to seek medical attention about symptoms.

Less common symptoms of lupus

A survey published in 2018 investigated the prevalence of specific lupus symptoms among individuals living with systemic lupus erythematosus (SLE) in the United Kingdom. This is the most common form of lupus.

Of the 2,527 survey respondents, 91% reported fatigue and weakness, and 77.4% reported joint pain or swelling.

The list below features some of the less common SLE symptoms that the survey respondents reported.


Angina refers to chest pain or discomfort that occurs when the heart does not receive enough oxygenated blood. Angina is not a Trusted Source disease but rather a symptom of an underlying heart issue, such as coronary heart disease (CHD).

In the survey of individuals with lupus, angina affected only 5.5% of respondents. However, a 2022 mini-review Trusted Source notes that angina is more prevalent among people with lupus than the general population.

According to the United Kingdom’s National Health Service, angina is a tight, heavy pain that may feel dull or sharp. It may spread to the arms, back, neck, or jaw and worsen with physical activity. It may also cause:

Stroke or mini-stroke

stroke occurs when one of the blood vessels carrying oxygenated blood to the brain becomes blocked or ruptures. The brain does not receive the blood and oxygen it needs to function, and brain cells begin to die.

A mini-stroke or transient ischemic attack (TIA) is a temporary blockage of blood flow to the brain. Its symptoms can be similar to those of a stroke but may only last a few minutes Trusted Source.

Of the survey respondents, 7.3% reported a history of stroke or mini-stroke.

According to the American Stroke Association (ASA),Trusted Source symptoms of stroke may include:

  • one-sided facial drooping or numbness
  • weakness or numbness on one side of the body
  • difficulty speaking or understanding speech
  • loss of balance or coordination
  • a severe headache

Pregnancy loss

According to the Centers for Disease Control and Prevention (CDC) Trusted Source, most women with lupus who conceive go on to have healthy pregnancies and babies.

However, the CDC recommends that a person’s lupus should be well-managed or in remission for 6 months or more before conceiving. This is because having an active lupus flare during pregnancy can result in pregnancy loss or stillbirth.

Almost 18% of women with lupus reported experiencing pregnancy loss in the survey.

The CDC notes that pregnancy may be high risk for women with lupus who have one or more of the following:

Kidney problems

According to the Lupus Foundation of America (LFA), lupus can cause a type of kidney disease called lupus nephritis (LN).

In LN, the kidneys become inflamed and stop functioning properly, causing a buildup of waste products in the blood and an accumulation of fluid in the body’s tissues.

For people who do develop LN, the condition usually occurs within 5 years of the start of their lupus symptoms.

In the survey, 17.5% of individuals with lupus reported experiencing kidney problems. Possible signs and symptoms of LN include:

Blood problems

In the survey, 27.5% of respondents reported blood problems as a symptom of lupus.

As the LFA notes, lupus can affect numbers of red blood cells (RBCs), white blood cells (WBCs), and platelets, which are blood cells that clump together to seal injuries and prevent blood loss.

Two blood disorders that lupus may cause are:

  1. Anemia: This involves low levels of RBCs or hemoglobin, a protein in RBCs that carries oxygen through the body. Symptoms may include tiredness, weakness, and shortness of breath.
  2. Thrombosis: This is excess blood clotting and may occur when platelet levels become too high. Symptoms include swelling, pain, and tenderness at the site of a clot. Larger blood clots may cause deep vein thrombosis and stroke.


According to the LFA, diagnosing lupus can be challenging as there is no single test to identify the condition. Diagnosis is typically a multi-stage process that can take months or even years. It may involve the following:

  • Symptom assessment: A doctor may ask about a person’s symptoms, including when they started, frequency, and if they affect daily functioning.
  • Family history: A doctor may ask if a person’s family members have an autoimmune disease. People who have a family member with an autoimmune disease may be at increased risk of developing lupus.
  • Lab tests: Although there is no single test for lupus, doctors may use blood testsurine tests, and biopsies to check for inflammation and other possible signs of the disease.

Ruling out other conditions

Before diagnosing lupus, doctors will also need to rule out other diseases that share similar symptoms. According to a 2023 reportTrusted Source, this may include the following:

When to speak with a doctor

A person with lupus should discuss any new or worsening symptoms with a doctor, as this may indicate a flare, complication, or a side effect of treatment.

The LFA also lists the following signs that a person should contact a doctor immediately:

  • severe abdominal pain
  • chest pain or shortness of breath
  • seizures
  • new onset of fever or worsening fever
  • excessive bruising or bleeding
  • confusion or mood changes
  • combined symptoms, such as a severe headache with fever and neck stiffness


Lupus is a chronic autoimmune disease that can cause widespread pain, inflammation, and tissue damage. This can result in a range of symptoms.

Some uncommon symptoms of lupus include angina, stroke and mini-stroke, pregnancy loss, kidney problems, and blood problems. Lupus can be difficult to diagnose, but reporting less common symptoms may help doctors make an accurate diagnosis.

A person should speak with a doctor if they experience new or worsening lupus symptoms. Symptoms such as chest pain, abdominal pain, and seizures indicate an urgent need for medical treatment.

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