Kidney problems affect many people who have lupus. These problems usually don't cause any symptoms, but some people may notice swelling in their legs or ankles (due to fluid retention) that they have not had in the past. The first sign of kidney problems is often abnormal urinalysis findings, such as protein, blood, or white blood cells in the urine or granular or red cell casts (clumps of red blood cells or kidney cells).
In a few cases, kidney problems are so severe that the kidneys stop working properly or fail completely. Depending on how severe kidney damage is, treatment can include strong medicines to control the lupus, kidney dialysis, or a kidney transplant.
- Inflammation of the sac around the heart (pericarditis). This is the most common lupus-related heart problem.
- Hardening of the arteries that supply blood to the heart muscle. People with lupus are at increased risk for plaque deposits in arteries (atherosclerosis) that may cause coronary artery disease. They are also likely to develop plaque deposits at an earlier age than people who do not have lupus.
- Diseases of the heart valves. A few people with lupus may have slightly thickened heart valves, which makes them more susceptible to infections of the damaged valves (endocarditis), blood clots, or heart failure. Some people with damaged heart valves may need surgery to replace the valves.
- Inflammation of the heart muscle (myocarditis), which is uncommon but may lead to problems with the heartbeat or heart muscle. The heart may beat too fast, too slow, or irregularly.
About 1 out of 3 people who have lupus develop inflammation of the tissue around the lungs.1 Sometimes this causes no symptoms. At other times it causes painful breathing, coughing, or chest pain that is worse with a deep breath (pleurisy). Many people with lupus have chest pain when they breathe. When this pain is not caused by pleurisy, it is commonly caused by inflammation of the chest muscle, cartilage, or ligaments, or of the joints that connect the ribs to the breastbone (costochondral joints). In these cases, the lungs may not be affected.
Less common lung problems with lupus include fever, cough, and inflammation of the lung tissue (acute lupus pneumonitis). Some people with lupus produce an antibody that causes their blood to clot more easily (antiphospholipid antibody). These people may be at risk for clots in the lung (pulmonary emboli). An unusual complication is the buildup of fluid in the lungs (pulmonary edema), caused by heart or kidney problems.