What are the differences and similarities between lupus (systemic lupus erythematosus) and multiple sclerosis (MS)? This is an important question, especially since some lupus patients are misdiagnosed with MS and vice versa. Understanding these differences can help you and your healthcare provider make the right diagnosis and treatment decisions.
Lupus and MS Basics
Lupus (systemic lupus erythematosus) and multiple sclerosis look similar in many ways. Both lupus and MS are chronic autoimmune diseases.
There are about 100 different autoimmune diseases with many overlapping symptoms.In these cases, the immune system—rather than attacking invaders such as bacteria or viruses—attacks your own body.
In lupus, the immune system may attack various organs in the body, especially the skin, joints, kidneys, heart, lungs, or nervous system. (Some forms of lupus affect only the skin, such as a condition called discoid lupus erythematosus.)
In multiple sclerosis, the immune system specifically attacks myelin, the fatty protective coating on nerve fibers in the brain and spinal cord. Myelin can be thought of as the outer shell of the wire.
Touching the wires can shock you when the cover is damaged or missing. When the myelin sheath is damaged, impulses between the brain and the body may not be transmitted properly.
Lupus and MS are very different diseases, but they have several things in common:
- They are both autoimmune diseases.
- We don’t know the exact reason.
- They are clinical diagnoses, which means no laboratory tests or imaging studies can confirm the diagnosis. Instead, the diagnosis of lupus or MS relies on a characteristic set of symptoms, signs, and laboratory tests that cannot be explained by another diagnosis.
- They affect people of the same age group. Both diseases most commonly affect the same population—young women—although they also affect other populations.
- They are both relapsing-remitting disorders. Both lupus and MS can follow a pattern of repeated remissions and relapses.
- They can both cause brain damage that looks similar on magnetic resonance imaging (MRI).
- Although nerves are the primary target of MS, lupus can sometimes affect nerves as well.
- Both conditions appear to have a genetic component and may run in families.
- Both conditions are often misdiagnosed in the first place.
- Both conditions can lead to fatigue, headaches, muscle stiffness, and memory problems.
In addition to the similarities, there are often some differences between lupus and MS. These differences are especially important because the treatments for the two disorders are often quite different.
MS is the most common neurological disorder affecting young adults. About half of people with lupus experience central nervous system (brain and spinal cord) symptoms. However, while both lupus and MS can affect the central nervous system, they tend to do so in different ways.
Lupus and MS have similar symptoms. Both diseases tend to cause:
- neurological symptoms, including memory problems
- muscle and joint pain
There are differences, however. In general, lupus causes more extensive damage to your body than MS, which primarily damages the nervous system.
multiple sclerosis symptoms
According to the National Multiple Sclerosis Society, the following common effects of lupus on the nervous system do not usually occur in people with MS:
- personality change
- changes in cognitive function
- stroke (less common)
The two most common symptoms of lupus are a rash and joint pain. In contrast, rashes are uncommon in MS, and the most common symptoms include:
- double vision
- Tingling or weakness in one of the extremities
- balance and coordination issues
Differences in lab tests
Antiphospholipid antibody testing is one way healthcare providers can begin to differentiate between lupus and MS. This antibody, also called lupus anticoagulant, increases the blood’s ability to clot. It is present in 50% of lupus cases.
Although antinuclear antibodies may be found in some people with MS, they are present in much lesser numbers than those with lupus.lupus is rare no Has antinuclear antibodies (ANA negative lupus).
Rarely, people with lupus will develop transverse myelitis. This condition is characterized by spinal cord inflammation and myelin damage. It mimics MS, sometimes the only lupus symptom. Therefore, it may confuse the diagnosis.
The study found that detection of antinuclear antibodies and anti-aquaporin 4 antibodies may help differentiate lupus and neuromyelitis optica from multiple sclerosis.
How imaging studies differ in MS and lupus
Generally, brain MRI will show more MS lesions (“black holes and bright spots”), but sometimes brain lesions found in lupus or MS may be indistinguishable.
When making a diagnosis, it is important to recognize the differences between lupus and MS, as the treatments for the two diseases are quite different.
The most common treatments for lupus include:
- Steroids (corticosteroids)
- Immunosuppressive drugs (DMARDS or disease-modifying anti-arthritis drugs) for severe disease, especially in cases involving major organs
The most common medications used to treat MS include:
- Interferon (such as Avonex)
- immunosuppressive drugs
With proper diagnosis and treatment, 80 to 90 percent of people with lupus will live a normal life. This forecast has improved significantly. In 1955, only half of people with lupus were expected to live more than five years. Now, 95% are alive after 10 years.
The life expectancy of people with MS is, on average, 7 years shorter than that of people without MS, but this can vary widely among people with the disease. Some people with very aggressive disease may die within a relatively short period of time, while many others live normal lives.
The impact of misdiagnosis
As mentioned above, there are several commonalities between lupus and MS that can lead to misdiagnosis:
- Both diseases are immune diseases.
- Both affect similar populations.
- Both have a relapsing-remitting course
- Both can cause neurological symptoms.
- Both can involve brain damage.
Because lupus and multiple sclerosis are treated with different drugs, one of the problems with misdiagnosis is that you won’t get the best treatment for your disease. But that’s not all: Some MS medications can make lupus symptoms worse.
Consult your healthcare provider if you have been diagnosed with lupus or MS, especially if your condition is considered “atypical.” Ask and learn about your diagnosis. If you don’t understand anything, ask again. If the diagnosis doesn’t seem right, be sure to mention it at your next appointment.
Make sure you see a specialist who treats lupus or MS specialists. You may also want to get a second opinion.Some people are reluctant to ask for a second opinion, but not only that no Offend your healthcare provider, but it’s to be expected when people are dealing with a serious medical condition.
You may feel like you’re dealing with the diagnosis on your own. Many people with MS are reluctant to talk about their condition in public, and people with lupus often find hurtful things being said when they learn about their condition.
Less is known about lupus or MS than many other diseases. Many symptoms are invisible to others, resulting in “silent distress.”
Consider joining a support group or online support community. This can be a great way to meet other people who are dealing with some of the same challenges, and often a great way to learn more about your disease and the latest research.
Frequently Asked Questions
Are MS symptoms in men the same as in women?
MS symptoms are mostly similar in men and women, but there are some differences.
- On brain scans, women sometimes had more inflammatory lesions than men.
- Neurodegeneration appears to affect men more strongly than women.
- Men may experience more severe cognitive problems, such as memory and decision-making.
- Women’s immune systems benefit more from vitamin D supplementation than men’s.
Are there different types of lupus?
Yes, there are four different types of lupus.
- Systemic lupus erythematosus (SLE): About 70% of people with lupus have this type. It causes acute and chronic inflammation of many organs and organ systems.
- Cutaneous lupus (lupus dermatosis): This type affects only the skin, causing rashes and lesions on areas including the arms, legs, face, ears, and neck. In fact, there are actually three subtypes: chronic cutaneous (disc) lupus, subacute cutaneous lupus, and acute cutaneous lupus.
- Drug-induced lupus: Caused by taking certain types of prescription drugs, most commonly hydralazine, procainamide, and isoniazid. There is no guarantee that everyone taking these drugs will develop lupus.
- Neonatal lupus: Babies born to women with lupus may be affected by this very rare type. Its most serious symptom is congenital heart block; however, it is easier than ever for doctors to spot and treat these underlying problems before birth.
Will you die from lupus?
It is possible to die from lupus, or, more specifically, from the health problems it causes, such as infections, kidney disease, and heart disease. However, people with lupus can live long, healthy lives with the help of professional treatment. This may include the use of nonsteroidal inflammatory drugs (NSAIDs), corticosteroids, antimalarial drugs, chemotherapy, immunosuppressants, etc.