Systemic lupus erythematosus history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]


A positive history of familial lupus, skin rashes (especially photosensitive skin rashes), arthritis, and fatigue may be suggestive of systemic lupus erythematosus. The most common symptoms of SLE include constitutional symptoms like fatigue, fever, myalgia, and weight changes. Other organ-specific symptoms mostly occur with disease progression. SLE may show a variety of symptoms in different organs depending on its complications.


Obtaining the history is one of the most important aspects in making a diagnosis of systemic lupus erythematosus. It provides insight into disease course and severity, precipitating risk factors, and associated comorbid conditions. Complete history will help determine the correct complication diagnosis, and helps in determining the prognosis as well. Specific histories about the symptoms (duration, onset, progression), associated symptoms, and drug usage have to be obtained. Specific areas of focus when obtaining the history are outlined below:

Common Symptoms

The early manifestations of systemic lupus erythematosus include common constitutional symptoms that may be seen in many other diseases as well:[1][2][3]

Less Common Symptoms

Organ system based signs and symptoms

Organ system Disease Symptom
Gastrointestinal Dysphagia 
Peptic ulcer disease
Intestinal pseudo-obstruction
Protein-losing enteropathy
Acute pancreatitis
Mesenteric vasculitis
Pulmonary Pleural disease
Pulmonary hemorrhage
Interstitial lung disease
Pulmonary emboli 
Pulmonary hypertension
Shrinking lung syndrome
Cardiac Valvular disease
  • Sharp, stabbing chest pain with a sudden start
  • Positional pain that decreases when sitting up and leaning forward
Coronary heart disease
Neurological CNS small vessle vasculitis
Genitourinary Nephrotic syndrome
Musculoskeletal Arthritis
Avascular necrosis
  • Asymptomatic
  • Mild to moderate pain in groin and lower abdomen in case of femoral head AVN
  • Secondary pain amplification
Skin disorder Cutaneous lupus erythematosus
Oral and nasal ulcers
  • Usually painless
Nonscarring alopecia
  • May occur at some point during the course of their disease


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