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Complications and Comorbidities

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

Lupus is a complex autoimmune disease with many possible complications and what are known as comorbidities. Comorbidity is a medical term that means a person has more than one medical condition. A complication is slightly different. A complication is a health problem that occurs as a result of the disease.

Many diseases tend to overlap with other health issues, and lupus is no exception. People with lupus often also have complications and comorbidities such as cardiovascular disease, metabolic syndrome, infections, fibromyalgia, cancer, osteoporosis, depression and anxiety, antiphospholipid antibody syndrome, and other autoimmune diseases.

Cardiovascular disease and lupus

Cardiovascular disease is the leading cause of death in people with lupus. Cardiovascular means heart (cardio) and blood vessels (vascular). Fifty percent experience high blood pressure, and chest pain, atherosclerosis (hardening of the arteries), pericarditis (inflammation of the heart), angina, Raynaud's phenomenon, and other heart and blood vessel issues are common.1,2

Kidney disease and lupus

Lupus nephritis is a severe and potentially life-threatening type of kidney disease that occurs when lupus attacks renal tissue. Up to 60 percent of people with lupus will develop lupus nephritis and 10 percent of those will go on to develop end-stage renal disease due to lupus nephritis.3,4

Skin complications and lupus

An estimated 66 percent of people with lupus develop some sort of skin disease during their lifetime, making it one of the most common complications of lupus. Rashes and sores (lesions) often appear on any skin exposed to the sun, such as the face, neck, arms, and legs.5

Metabolic syndrome and lupus

Metabolic syndrome, a cluster of health conditions that can lead to type 2 diabetes, is common in people with lupus. Metabolic syndrome includes obesity, high cholesterol, high blood pressure, and elevated blood sugar levels. Doctors believe metabolic syndrome in people with lupus is caused by a combination of the disease itself, steroid use, and lifestyle issues, such as lack of exercise.6

Infections and lupus

Some infections are more common in people with lupus because their immune system is weakened either by the disease itself or the immunosuppressants used to control the condition. The opportunistic infections most often seen in people with lupus are herpes zoster, staphylococcus aureus, E.coli, salmonella, and Candida albicans.

Fibromyalgia and lupus

Roughly 30 percent of people with lupus will also be diagnosed with fibromyalgia, another condition that causes fatigue, and widespread, sometimes extreme muscle pain and sensitive spots on the body.7

Cancer and lupus

People living with lupus have a greater risk of developing several kinds of cancers, including blood, gastrointestinal, and lung. The types of cancer linked to lupus include bladder, cervix, esophagus, gastric, hepatobiliary, lung, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, larynx, leukemia, multiple myeloma, non-melanoma skin, oropharynx, renal, thyroid, and vagina/vulva cancers.8

Osteoporosis and lupus

Both the disease itself and the steroids that help control lupus symptoms contribute to a weakening of the bones, or osteoporosis.

Central nervous system

Lupus impacts the central nervous system (brain, spinal cord, and nerves) in many ways, with 25 percent to 75 percent of people with the disease reporting symptoms. Depression and anxiety are common, as are a stroke, headaches, meningitis, eye disease, brain fog, seizures, and psychosis.9

Antiphospholipid antibody syndrome and lupus

People with lupus are significantly more likely to develop a disorder called antiphospholipid antibody syndrome (APS). With APS, the body creates antibodies that attack the proteins in the blood that control blood clotting. When a person develops APS, they tend to develop blood clots in the arteries and veins, miscarry, or develop thrombocytopenia (low platelet count).

Other autoimmune diseases

Scientists do not understand why, but people with lupus also often develop a second or third autoimmune disease. Some of the most common diseases that overlap with lupus are celiac disease, myasthenia gravis, rheumatoid arthritis, scleroderma, and Sjogren’s syndrome.

Other complications

Since lupus can attack any tissue anywhere in the body, the lungs, digestive tract, eyes, joints, and blood can all be harmed by the inflammation of lupus too.

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