At a glance, it can be difficult to tell lupus and multiple sclerosis (MS) apart. Both are chronic autoimmune diseases that can cause a variety of symptoms, including fatigue, muscle weakness, and confusion. But lupus and MS are very different conditions. Each has its own set of distinctive symptoms, causes, and treatments.
If you are experiencing any symptoms that align with either lupus or MS, talk to your neurologist. A doctor specialized in neurology will be able to provide a thorough exam, blood tests, imaging, and a professional differential diagnosis of MS or lupus.
Lupus is an autoimmune disorder that affects roughly 5 million people worldwide. Like other autoimmune diseases, lupus symptoms occur as the result of the body’s immune system mistakenly attacking the body’s healthy tissues, causing inflammation. This inflammation can have a negative impact on the heart, brain, lungs, skin, kidneys, joints, and blood cells.
Lupus is more common among some groups than others. For example, 90 percent of people with the condition are women, and lupus is up to three times more common among women of color.
There are several different kinds of lupus. These types can vary depending on their causes and symptoms.
The name lupus is most often used during diagnosis as a general way of referring to systemic lupus erythematosus (SLE). Doctors refer to SLE as systemic because it typically affects several organ systems at the same time. SLE is the most common type of lupus (and the most severe), affecting about 70 percent of people with the condition.
Chronic cutaneous lupus erythematosus only affects the skin. Although this type of lupus can exist in people without systemic lupus, 5 percent or more of people with this form may develop SLE.
Drug-induced lupus, which accounts for 1 in 10 cases of the disease, can develop after taking certain types of medications. Although similar to SLE, drug-induced lupus is temporary. It tends to disappear within months after discontinuing the medication causing it.
This is a very rare type of lupus that occurs when a mother’s antibodies attack her baby during pregnancy. This can cause rashes, liver problems, and low blood counts in the baby. However, symptoms usually fade after about 6 months.
Similar to lupus, multiple sclerosis (MS) is a chronic inflammatory disease. However, instead of causing inflammation across several body systems, MS targets one: the central nervous system (CNS). In people with MS, the body’s defenders (white blood cells) attack the central nervous system, which includes the brain and spinal cord. These attacks cause inflammation and strip the nerves of their protective coating (myelin). This process is called demyelination and leaves the nerves vulnerable, reducing their ability to transmit electrical signals.
Over time, this demyelinating process can cause people with MS to experience a variety of symptoms that affect physical movement, eyesight, and cognitive (mental) functioning.
There are three main types of MS: relapsing-remitting, secondary progressive, and primary progressive.
This is the most common type of MS, affecting 8 in 10 people with the condition. Generally, people with relapsing-remitting MS will experience relapses, or sudden symptomatic periods, that appear and slowly fade over a few weeks or months.
This type of MS is identified by an initial relapsing-remitting MS disease course, which is then followed by progressive worsening of symptoms. This occurs with or without new relapses, minor remissions, and symptom plateaus. According to the UK’s National Health Service (NHS), roughly half of people with relapsing-remitting MS develop secondary progressive MS within 15 to 20 years of being diagnosed with multiple sclerosis.
This is the rarest type of MS, affecting 1 in every 10 people with the condition. Those with primary progressive MS do not experience relapses. Instead, their symptoms gradually increase and become more severe over time.
Researchers estimate that MS affects around 2.5 million people globally. Women are more likely to experience it than men, and initial symptoms tend to appear sometime between the ages of 20 and 50.
Lupus and MS have some symptoms in common. The symptoms of both illnesses can vary from person to person. However, there are several key differences between the two that may help in diagnosing one or the other.
Lupus can vary widely between people. Some people might only experience a few mild, temporary, slow-developing symptoms, whereas others may face several long-term, severe effects.
The most identifiable lupus symptom is the malar rash, or butterfly rash — a redness that spreads over the bridge of the nose and cheeks and resembles a butterfly. Although most easily identifiable on the face, malar rashes can also appear on the shoulders, chest, hands, arms, face, and ears. These can be (but are not always) itchy or painful. These rashes typically fade after a few days or weeks.
There are other common symptoms. According to the Lupus Research Alliance, between 50 percent and 90 percent of people with the condition point to fatigue as one of their primary symptoms. Approximately 90 percent also experience arthritis — an inflammation of the joints that can cause pain, swelling, and stiffness, often in the wrists and hands. People with lupus can also experience arthralgia (joint pain without swelling and tenderness).
Other symptoms commonly associated with lupus include fevers, skin lesions, headaches, depression, and fingers that turn pale or blue when under stress or in cold environments. People living with lupus are at increased risk for heart and kidney problems, diabetes, blood clotting disorders, and spinal cord inflammation.
No two people with MS have the same experience. Symptom severity can vary, and the problems that a person experiences depend on which nerve fibers have been damaged.
According to the National Multiple Sclerosis Society, many people with MS experience movement impairment. Physical symptoms of MS may include muscle weakness, unsteady gait (walking), numbness and tingling sensations, and spasticity (stiffness or involuntary muscle spasms). Other symptoms include lack of coordination, imbalance, and dizziness.
Fatigue is a major symptom of multiple sclerosis, as are cognitive (brain) changes. “There is only so much schoolwork I can do in a day,” one MyMSTeam member shared, explaining that her MS made it difficult to concentrate and retain information.
Those with MS may also experience vision abnormalities, such as blurring, color blindness, and painful eye movements. Emotional and neurological symptoms, including depression and mood swings, are common, as are bladder, bowel, and sexual dysfunction.
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