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It is important for you to know the warning signs and symptoms of lupus. Complete this simple checklist to help you recognize the symptoms and risk factors for lupus. Answer each question in terms of your current and past health status. If you have had symptoms like these, especially if you have had several, talk to your doctor about lupus. After completing the symptom checklist you will have the option to print out a report with your answers to take with you to your doctor. The checklist is only meant to help you recognize the signs and symptoms of lupus, and as a guide for you and your doctor to discuss your possible risk for developing lupus.
Signs and Symptoms of Lupus
For each symptom listed select
“yes”
to the ones you have experienced in the past, or are currently experiencing. If you are unsure select
“don’t know.”
1. Achy, painful and/or swollen joints for more than three months.
Yes
No
Don't know
2. Fingers and/or toes become red or blue, or feel numb or painful.
Yes
No
Don't know
3. Sores in your mouth or nose that lasted more than five days, or sores on your skin that would not heal.
Yes
No
Don't know
4. Anemia, a low white blood cell count, or a low platelet count.
Yes
No
Don't know
5. Redness or rash in the shape of a butterfly across your nose and cheeks.
Yes
No
Don't know
6. A fever over 100° F for more than a few days.
Yes
No
Don't know
7. Photosensitivity, a reaction to sun or light that causes a skin rash to appear or get worse.
Yes
No
Don't know
8. Chest pain while taking deep breaths.
Yes
No
Don't know
9. Protein in your urine, or swelling in your legs and ankles on both sides at the same time.
Yes
No
Don't know
10. Persistent, extreme fatigue and weakness for days or weeks at a time, even after plenty of sleep.
Yes
No
Don't know
11. Seizure or unexplained confusion that last for more than an hour.
Yes
No
Don't know
12. Blood clot(s).
Yes
No
Don't know
13. Heart attack or stroke.
Yes
No
Don't know
14. Miscarriage(s).
Yes
No
Don't know
15. Sudden, unexplained hair loss.
Yes
No
Don't know
Risk factors for lupus
Gender, ethnicity, age, and family medical history may all contribute to your risk of lupus. Nine out of 10 people who develop lupus are women, and most women develop lupus between the ages of 15 and 44. Hispanic, Asian, Native American and African American women are also two to three times more likely to develop lupus than Caucasian women.
1. What is your current age?
2. Ethnicity:
Caucasian
African American
Hispanic/Latino
Asian
Native American or Alaska Native
Native Hawaiian or Pacific Islander
Mixed race
3. Gender:
Female
Male
4. Does your family have a history of autoimmune disorders such as rheumatoid arthritis, Sjögren's syndrome, type 1 diabetes, Raynaud's phenomenon, scleroderma, mixed connective tissue disease, multiple sclerosis (MS), or over- or under-active thyroid?
Yes
No
Don't know
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