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nas2m, hello, welcome, and congratulations on your (almost) new son. I remember a phrase I read years back about lupus, that it's a disease of "protean manifestations", meaning ever-changing. Many of us bounce in & out of a grab-bag of recurring problems, I think, with the goal being to work those down to the smaller, do-able stuff. From an old list in my files, here are common SLE problems.

ARTHRITIC PAIN (90% of patients). Often with swelling & redness. Ranges from mild to severe. May migrate from one joint to another. Often bad in morning, better midday, then bad again as you tire later in the day. Joints often involved are fingers, wrists, elbows, knees and ankles.

FEVER (90% of patients). Usu. low-grade, except during acute crises.

SKIN RASHES (75% of patients). In about half, UV light aggravates. 20% get the discoid kind, which tend to scar &/or depigment; 10% of these go onto develop systemic lupus. Malar butterfly: tends not to scar but can damage capillaries. Subacute cutaneous: these are coin-shaped but tend not to scar/depigment; while many with SCLE lesions meet 4 or more diagnostic criteria, the risk of CNS & kidney problems may be lower in that group.

BLOOD COMPLICATIONS (roughly 85%). Anemia is very common. Antiphospholipid antibodies may create "sticky blood". Thrombocytopenia (low platelets) may cause bruising & bleeding. Hemolytic anemia may premtaurely destroy red blood cells. Neutropenia may cause low white blood cell count. Inflammation may reduce circulation, and cold and stress may impair flow in fingers & toes (this is called Raynaud's phenomenon).

HEART. Younger women with SLE are at higher risk of heart attack and stroke, but risk for older women with SLE is thought to be surprisingly low. High cholesterol. Pericarditis (inflammation of tissue around heart, causes pain). Inflammation of heart muscle (myocarditis). Elevated homocysteine (present with depressed B6, B12, and folic acid), which correlates to risk of heart attack, stroke, and blood clots.

LUNGS (about 60% of patients). Most common is pleurisy (inflammation of membrane lining). Fluid accumulation is called pleural effusion, which causes stabbing pain. Lung inflammation in SLE is called lupus pneumonitis, caused by infections or by the SLE itself. Pulmonary hypertension (high blood pressure in vessels supplying lungs) is serious but rare.

KIDNEY (50% of patients but reaching serious level in only about 30%). In it, inflammation damages capillaries, which affects kidneys ability to filter waste products from blood.

CNS. Damage can occur to nerves & their myelin covering. When meaningful CNS damage occurs, it usually accompanies involvement of some other organ(s), and most likely within the first year. However, many people have milder transient issues, like headaches, anxiety, depression, etc.

INFECTIONS. In lupus, the immune system is overactive, but it's aberrant, so ability to fight infections is reduced. Patients are more vulnerable to streptococcal, staphylococcal, fungal, and parasitic infections; also herpes, salmonella, and yeast infections. Meds like steroids and immune suppressants also increase vulnerability.

GI PROBLEMS. Nausea, weight loss, pain, diarrhea, fluid retention and swelling. Also pancreatitis, from steroids or SLE itself.

JOINT, MUSCLE, AND BONE. Lupus arthritis hardly ever causes joint deformity. But inflammation can cause muscle weakness and damage. Bone density is affected: osteoporosis is common.

EYES. Blood supply to retina can be impaired, causing nerve cell degeneration and retinal hemorrhage.

OTHER. Fatigue, loss of appetite & weight loss, nausea, chest pain, bruising, periodic irregularities, disturbances of thought & concentration ("brain fog"), personality changes, hair loss (thinning, breakage, and alopecia), migraines (2-3 times more likely in lupus than in people without), and sleep disorders (like restless legs and sleep apnea).

SEVERITY & FLARES. 20% to 30% remain overall mild; 50% to 75% have some vital organs affected at some point. Flares often occur 2-3 times yearly.

Have you read the "sticky posts" (permanent info posts) at the top of the thread list? Among other info, you'll find some books written for patients that you can borrow, for free, from most libraries. But the most important things to absorb from all this are that (1) you certainly aren't "guaranteed"" all the above problems, (2) many people with lupus manage pretty well, when taking appropriate medication and having regular follow-ups, and (3) lupus LOVES hormonal shifts, so here's hoping that your being post-partum alone has reduced your vulnerability.

How are you feeling now? Do you have a good rheumatologist and nephrologist? Are you on medications? (I take only Plaquenil but also used Fiornal or Bellergal when I was still getting killer headaches. Plus I take OTC's like Advil, for extra help with arthritic pain.) Have you asked your drs. for help with your headaches?

I hope this is what you're after, but as I said, do NOT let it panic you. (Knowledge is power!) And read more, as reading never hurts. Plus I hope you'll post regularly here---you'll find kindred spirits with a wide range of personal experience. Sending my best wishes to you, and to your baby boy, too! Sincerely, Vee





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