Your chest hurts

If it hurts to cough or breathe deeply, it could be pleurisy—inflammation of the lining of the lungs. It’s a common symptom of lupus. “If you cough and the lung tissue gets pushed out against the lining, it hurts because it’s inflamed,” Dr. Goldfien explains. “It tends to be a sharp pain.”

Lupus may also inflame the lining of your heart, which causes chest pain, too. This type of chest pain changes based on your position. “If you lie down on your back, it hurts,” he says, “and if you sit up and lean forward, it feels better.”

You have mouth sores

“When I see someone who I think might have lupus, I ask them if they get sores in their mouth,” Dr. Goldfien says. Ulcers, like canker sores, on the roof of the mouth or tongue or even the nose, can last a few days to a month or more, according to the American College of Rheumatology.

Red dots appear on your skin

Petechiae may occur in some lupus patients.

Lupus can attack your platelets, blood cells that help your body form clots to stop bleeding, Dr. Manzi explains. And when you have low levels of platelets, you can develop tiny red dots called petechiae.

“People will notice little red blood spots on their legs because their blood vessels are leaking blood,” she says. They may also get nosebleeds or be bleeding from their gums when they brush their teeth. It suggests that “the platelets may be under attack,” Dr. Manzi says.

Your head hurts, and you can’t think straight

It’s not all in your head: lupus can attack the brain and nervous system. Up to 50 percent of people with lupus report problems with memory, concentration, and other cognitive issues dubbed “lupus fog,” says the National Resource Center on Lupus. People with lupus may be twice as likely to develop migraine-like headaches due to inflammation of the blood vessels. And when lupus attacks the nerves, they can experience numbness or tingling in the motor and sensory nerves.

“If a young woman in her 30’s, 40’s comes in with a stroke, and everyone’s thinking, ‘How could this happen?’ oftentimes that’ll be the onset of a diagnosis of lupus,” Dr. Manzi says.

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