MS vs. Lupus: Similarities and Differences

Multiple sclerosis (MS) and lupus are two different diseases, but they have a lot in common.

MS and lupus: similarities

MS and lupus may both cause these symptoms in some people:

To diagnose either lupus or MS, you’ll need lots of tests. There isn’t a single blood test or imaging scan result that confirms you have either condition. Diagnosis isn’t simple and requires multiple tests.

Both MS and lupus can cause a positive antinuclear antibody (ANA) blood test. Doctors use the ANA test to help confirm a lupus diagnosis, but not everyone with lupus is ANA-positive. While your ANA test can be positive if you have MS, it’s used more to rule out lupus as a cause of your symptoms, not to help diagnose MS.

MS and lupus are similar in other ways too:

Both MS and lupus are lifelong (chronic). You’ll live with them for good, and you’ll feel better or worse at times. Both conditions may go into remission for long periods of time. Your symptoms may mostly go away, then flare up again.

They’re both autoimmune diseases. In MS, your own immune system attacks your nervous system by mistake and damages your nerves. In lupus, your immune system attacks healthy tissues like your skin, joints, kidneys, heart, or lungs. But it can also damage your nerves and brain.

They’re both more common in younger women. The most common type of MS is up to 3 times more likely to happen to women than men, usually between ages 20 and 40. Lupus is also more common in women, and often first appears between your teens and mid-40s.

MS and lupus: key differences

While both MS and lupus are autoimmune diseases, they happen for different reasons. MS is caused by immune cells that cross your blood-brain barrier and damage your central nervous system. In lupus, one type of immune cell, B cells, cause you to make autoantibodies that damage tissues and organs all over your body.

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Lupus and MS usually cause different symptoms. This may help your doctor rule out the diseases you don’t have to confirm your diagnosis.

  • Lupus often causes skin rashes, arthritis, mouth sores, sun sensitivity, hair loss, or kidney problems, but these symptoms don’t show up in MS. Even when lupus affects your nervous system, its most common symptoms are migraine, personality changes, seizures, or stroke, but these aren’t typical for MS.
  • Common MS symptoms include electric shocks when you move your neck, vision problems, slurred speech, and bladder or bowel problems. These aren’t lupus symptoms.

Doctors use different tests to help confirm either MS or lupus. Lupus diagnosis is based on your symptoms, plus blood and urine tests, imaging scans, and sometimes, biopsy results. MS diagnosis is based on your symptoms, plus a blood test, spinal tap exam, MRI scan, and the evoked potential test to check electrical signals in your nerves.

Other key differences between MS and lupus include:

Risk factors: If you’re white, you’re at higher risk for MS but not lupus. If you’re of Black, Asian, Native, or Hispanic descent, you’re at higher risk for lupus but not MS.

Pregnancy issues: Women with lupus find it harder to get pregnant. They have a higher risk of preeclampsia and miscarriages. Women with MS usually don’t have any problems getting pregnant, but may have smaller babies, and may have trouble during labor or need a cesarean section.

Treatments: While biologics, drugs that tamp down your overactive immune system, are used to treat both diseases, different ones are used in lupus and MS.

Is one condition worse than the other?

Both MS and lupus are serious diseases, but you may not have the same experience or symptoms as someone else with the same diagnosis. New treatments are more effective at treating MS and lupus symptoms now. Your risk of serious complications or shortened life span is also lower than it was in the past.

Can you have both MS and lupus?

It’s very rare, but a small number of people have been diagnosed with both MS and lupus. However, none of them had severe forms of either disease.

WebMD Medical Reference Reviewed by Christopher Melinosky on August 18, 2020

Sources

SOURCES:

FamilyDoctor.org: “What Is Lupus?”

Mayo Clinic: “Multiple sclerosis,” “Lupus.”

NYU Langone Health: “Diagnosing Systemic Lupus Erythematosus.”

UCSF Health: “Multiple Sclerosis.”

National MS Society: “Depression,” “Lupus,” “Multiple Sclerosis FAQs.”

MS Focus Multiple Sclerosis Foundation: “Diseases That Mimic MS.”

MSLivingWell.org: “Diagnosing Multiple Sclerosis.”

Lupus Foundation of America: “What Is Lupus?”

Multiple Sclerosis Journal -- Experimental, Translational, and Clinical: “Coexistence of systemic lupus erythematosus and multiple sclerosis. A case report and literature review.”

March of Dimes: “Multiple Sclerosis and Pregnancy.”

Seminars in Arthritis and Rheumatism: “Coexistence of systemic lupus erythematosus and multiple sclerosis: prevalence, clinical characteristics, and natural history.”

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