Complaints & connections · borters.ch
Lupus is an illness of the whole body, not of the skin alone — and it runs in flares.
Also known as: SLE · butterfly disease · autoimmune disease of the whole body
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Lupus is systemic. That is the sentence which orders everything else: the illness keeps to no single organ and can affect several at once — which is why it rarely looks the same in two people. Possible are: the joints (pain that moves around and swelling, but without the lasting deformity of rheumatoid arthritis), the skin (redness over cheeks and bridge of the nose, sensitivity to sun, hair loss), the mucous membranes (painless sores in mouth or nose), the kidneys (silent, painless, recognisable only by protein in the urine), the blood (too few white cells, too few platelets, anaemia), the sac around the heart and the lining of the lung (pain on deep breathing), the nervous system (headache, altered sensation, more rarely beyond) and the vessels (white or blue fingers in the cold, a raised tendency to clots).
Nobody has all of it. The rule is rather: a few building blocks, in flares, shifting over years. And a rash is not required — in many it starts in the joints, with tiredness, slight fever and weight loss, while the skin stays unremarkable for a long time. That is exactly why lupus is often only recognised after months to years.
With the values, understanding helps more than a list. ANA is positive in practically everyone — but it is also weakly positive in about 5 to 15 of 100 healthy people, so alone it proves nothing. Anti-dsDNA is clearly more specific and often rises with activity, above all at the kidney. Complement C3 and C4 falls in a flare because it is consumed — a falling value says more here than a single one. And a peculiarity: the sedimentation rate is often high while CRP stays normal. If CRP rises markedly, an additional infection is thought of sooner than the lupus itself.
Two things matter more than all the rest. First the kidney: it does not hurt and announces itself only through protein in the urine — which is why a urine strip belongs to every check, even when one feels well. Second the sun: sunlight can set off a flare, not at once but hours to days later. The diagnosis in the end always comes from signs, course and values together, never from a single test. If more than half a gram of protein a day is repeatedly measured in the urine, a closer kidney assessment with a tissue sample follows; checks are every three months.
What lupus shares with around eighty others, and why they rarely come alone.
Not cosmetics: light can set off a flare, delayed by hours to days. Shade, clothing, high protection all year.
A urine strip for protein at every check — especially when one feels well.
Smoking clearly worsens the course and the response to treatment.
Dry eyes and dry mouth often come with lupus and are rarely mentioned unprompted.
There the joints deform over time, here mostly not — one of the most usable differences.
Sun sensitivity, blood count and kidney are exactly the points where medicines and supplements meet. The calculator shows the routes.
Often the beginning. Unlike rheumatoid arthritis the joints usually stay intact, even when it hurts a great deal.
The redness over cheeks and nose is well known, but in many it is entirely absent. Looking only for it misses most beginnings.
The delay is why the connection often goes unnoticed. Not only the skin reacts — tiredness and joints can follow.
Precisely because they do not hurt they are rarely mentioned. A look at the palate therefore belongs to the examination.
It comes and goes with activity. If scars remain on the scalp that is a form of its own and belongs looked at.
These three together are why an infection or the thyroid is often thought of first.
Sac around the heart or lining of the lung. A sign worth reporting, because it changes the treatment.
No pain, no feeling. Only protein in the urine, sometimes foam when passing water or swollen ankles in the evening. Hence the strip test at every check.
Common in lupus. On its own the phenomenon is usually harmless; here it is one building block of the picture.
Positive in practically everyone — a negative makes lupus very unlikely. Positive alone proves nothing: 5 to 15 in 100 healthy people have it weakly.
Clearly more specific than ANA and often a measure of activity, above all at the kidney. Usually only measured when ANA was positive.
Falls in a flare because it is consumed. The course says more than a single value.
Mostly only moderate in lupus. A clearly high CRP points rather to an additional infection.
The point that decides the treatment. The urine strip costs almost nothing and belongs to every check.
Vegetables, fish, olive oil; sparing with salt when the kidney is involved.
In the pain-free range, matched to the flare. Against the tiredness it works better than resting.
AWMF 060-008 · S3 · 2025-07 — in force
Management des systemischen Lupus erythematodes
checked 2026-09