7 Conditions Confused With Lupus

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    A Challenging Diagnosis
    Lupus is an autoimmune disease that affects 1.5 million Americans—90% of whom are women. But diagnosing lupus can be challenging because symptoms tend to come and go in “flares” that are hard to track. There is no one definitive test for lupus. Doctors look at the combination of your symptoms and a series of lab tests to diagnose lupus. Lupus is often called “the great imitator” because it has the same symptoms—including joint pain, fatigue, headaches, rashes, hair loss, inability to concentrate, and swelling—as many other diseases. Here are seven conditions that are frequently confused with lupus.

  • Older Caucasian woman on couch experience stomach and back pain
    1. Fibromyalgia
    Fibromyalgia is a treatable chronic disorder characterized by extreme fatigue and muscle pain. People with fibromyalgia may also have headaches, difficulty concentrating, sleeplessness, painful menstrual cramps, and joint stiffness—all hallmarks of lupus. And if you have lupus, you are more likely to have fibromyalgia. Doctors diagnose fibromyalgia by ruling out other similar conditions like rheumatoid arthritis, and by asking you questions about your symptoms, such as where on your body you feel pain and for how long you’ve had pain.

  • woman rubbing joints on hand
    2. Rheumatoid Arthritis
    Like lupus, rheumatoid arthritis (RA) is an autoimmune disease. Symptoms of RA include joint stiffness, swelling, and pain, especially in the feet and hands. Lupus and RA also share many of the same complications, including anemia (low red blood cell count), pericarditis (swelling of the lining around your heart), vasculitis (swelling of small blood vessels) and atherosclerosis (inflammation of the arteries). Doctors diagnose rheumatoid arthritis by looking at key clinical patient information. These include your symptoms, a physical exam, blood tests, and X-rays.

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    3. Hypothyroidism
    Hypothyroidism occurs when your body does not produce enough thyroid hormone. Symptoms that mirror those of lupus include fatigue, hair loss, muscle and joint pain, and painful menstrual periods. As with fibromyalgia, people with lupus are more likely to have hypothyroidism. Doctors measure blood levels of thyroid stimulating hormone and thyroid hormone levels, along with your symptoms, to diagnose hypothyroidism.

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    4. Skin Conditions
    Several skin conditions can be confused with the skin rash and skin redness that sometimes occur with lupus. Rosacea involves redness of the skin on the face, especially around the nose and cheeks (where the “butterfly rash” characteristic of lupus also shows up). Other skin conditions that sometimes mimic the skin problems of lupus include melasma, psoriasis, eczema (atopic dermatitis), and facial seborrheic dermatitis. A dermatologist can diagnose these skin conditions.

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    5. Depression
    The symptoms of clinical depression can mimic lupus symptoms, and vice versa. These overlapping symptoms include fatigue, difficulty concentrating, and feelings of achiness and pain. People with lupus may feel depressed, so it’s important to know if you have lupus and are depressed, or if you are depressed but don’t have lupus. To find the answer, first talk with your primary care doctor or a rheumatologist—a doctor with experience in diagnosing lupus. Your doctor may refer you to a psychologist for a diagnosis.

  • Sick woman taking her temperature
    6. Unrecognized Viral and Bacterial Infections
    It’s not uncommon to mistake lupus symptoms for symptoms of various viral and bacterial infections. Lyme disease is a bacterial infection that has many lupus-like symptoms, including fatigue, headaches, joint pain, fever, and skin rashes. Parvovirus B19 (fifth disease) also has lupus-like symptoms, including a cheek rash, joint pain, and headache. Other infections that share symptoms with lupus include hepatitis C and HIV. If your doctor says you have an infection and your symptoms don’t improve over time with conventional therapies, ask your doctor if it makes sense to explore the possibility that you have lupus.

  • Woman holding cane
    7. Multiple Sclerosis
    Multiple sclerosis (MS) is a disease of the central nervous system that, like lupus, can cause symptoms that come and go and change over time. MS also has symptoms characteristic of lupus (and many other conditions)—including fatigue, pain, and diminished ability to focus. Doctors do physical and neurologic exams, MRI (magnetic resonance imaging), blood and spinal fluid analysis, and evoked potential (EP) testing to diagnose MS.

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    Key Takeaways
    Unfortunately, there is not a simple blood test for lupus. Doctors base their diagnosis on a set of clinical signs and symptoms, including physical traits and specific skin, heart and lab test results. The problem is that symptoms change and are similar to other conditions. If you have symptoms like fatigue, muscle pain, and headaches, learn about the different conditions that can cause them. Find a rheumatologist with extensive experience treating people like you. This can empower you to work with your doctor and pinpoint the best diagnosis and treatment that’s right for you.

7 Conditions Confused With Lupus

About The Author

  1. Living With Lupus: Health Information Basics for You and Your Family. National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Lupus/do_i_have_lupus.asp
  2. Lupus. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Lupus
  3. What are the common symptoms of lupus? Lupus Foundation of America. http://www.lupus.org/answers/entry/common-symptoms-of-lupus
  4. What are the diagnostic criteria for lupus? Lupus Foundation of America. http://www.lupus.org/answers/entry/lupus-diagnostic-criteria
  5. What Is Fibromyalgia? National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 
  6. Rheumatoid Arthritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis
  7. Rooney J. Systemic lupus erythematosus: unmasking a great imitator. Nursing. 2005;35(11):54-60.
  8. Lyme Disease. Centers for Disease Control and Prevention. http://www.cdc.gov/lyme/
  9. Depression. National Institutes of Health. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/depression/index.shtml
  10. About Psoriasis. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis
  11. Hypothyroidism. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/endocrine/hypothyroidism/Pages/fact-sheet....
  12. Pyne D and Isenberg D. Autoimmune thyroid disease in systemic lupus erythematosus. Ann Rheum Dis. 2002; 61(1):70–72.
  13. Definition of MS. National Multiple Sclerosis Society. http://www.nationalmssociety.org/What-is-MS/Definition-of-MS
  14. Lupus Fact Sheet. Lupus Research Institute. http://lupusresearchinstitute.org/lupus-facts/lupus-fact-sheet
  15. Fibromyalgia. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
  16. What are the laboratory tests for lupus? Lupus Foundation of America. http://www.lupus.org/answers/entry/lupus-tests
  17. Diagnosing Tools. National Multiple Sclerosis Society. http://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 1
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.