Table of ContentsView AllTable of ContentsBasicsSimilaritiesSymptomsLab TestsTreatmentPrognosisMisdiagnosisFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Basics
Similarities
Symptoms
Lab Tests
Treatment
Prognosis
Misdiagnosis
Frequently Asked Questions
What are the differences and similarities betweenlupus (systemic lupus erythematosus)andmultiple sclerosis (MS)? This is an important question, especially since some people with lupus are misdiagnosed as having MS and vice versa.Knowing the differences can help you and your healthcare provider make the right diagnosis and treatment decisions.
Verywell / Jessica Olah
Lupus and MS Basics
Lupus (systemic lupus erythematosus) andmultiple sclerosiscan appear similar in many ways. Both lupus and MS are chronicautoimmune diseases.
More than 100 different autoimmune diseases exist, with many overlapping symptoms.In these conditions, the immune system—instead of attacking an invader such as bacteria or viruses—attacks your own body.
In lupus, the immune system may attack various organs in the body, particularly the skin, joints, kidneys, heart, lungs, or nervous system. (Some forms of lupus only affect the skin, such as a condition known asdiscoid lupus erythematosus.)
In multiple sclerosis, the immune system specifically attacks themyelin sheath, the fatty protective layer on nerve fibers in the brain and spinal cord. The myelin sheath can be thought of as the outer cover of an electrical cord.
When the cover is damaged or missing, touching the wires could give you a shock. When the myelin sheath is damaged, impulses between the brain to the body may not be transmitted properly.
Lupus and MS are very different diseases, but they have several things in common:
Differences
In addition to the similarities, there are several differences commonly found between lupus and MS. These differences are especially important as the treatments for the two diseases are usually quite different.
MS is the most common neurological disease that strikes young people. About half of lupus patients will have central nervous system (brain and spinal cord) symptoms. Yet, while both lupus and MS can affect the central nervous system, they tend to do so in different ways.
Differences in Symptoms
Lupus and MS have similar symptoms. Both diseases tend to cause:
Yet there are differences as well. In general, lupus does more generalized damage to your body than MS, which primarily damages the nervous system.
Lupus Symptoms
Two of the most common symptoms of lupus are rashes and joint pain. The following common effects of lupus on the nervous system do not typically occur in people with MS:
MS Symptoms
In contrast, rashes are uncommon with MS. The most common MS symptoms include:
Differences in Laboratory Tests
Antiphospholipid antibodytesting is one way that healthcare providers can start to distinguish lupus from MS. This antibody, also calledlupus anticoagulant, increases the ability of the blood to clot. It’s found in 50% of cases of lupus.
Whileantinuclear antibodiesmay be found in some people with MS, their presence is much less common than with lupus. With lupus, it is rarenotto have antinuclear antibodies (ANA-negative lupus.)
Studies have found that testing for antinuclear and anti-aquaporin-4 antibodies may be helpful in distinguishing lupus andneuromyelitis opticafrom multiple sclerosis.
How Imaging Studies Differ in MS and LupusIn general, a brain MRI will show more lesions with MS (“black holes and bright spots”) but sometimes the brain lesions found with lupus or MS can be indistinguishable.
How Imaging Studies Differ in MS and Lupus
In general, a brain MRI will show more lesions with MS (“black holes and bright spots”) but sometimes the brain lesions found with lupus or MS can be indistinguishable.
Differences in Treatments
It is important to recognize the differences between lupus and MS when making a diagnosis because the treatment for the two conditions is quite different.
The most common treatments for lupus include:
The most common medications used to treat MS include:
Differences in Prognosis
With proper diagnosis and treatment, between 80% and 90% of people with lupus will live a normal lifespan. That prognosis has improved significantly. In 1955, only half of people with lupus were expected to live beyond five years. Now, 95% are alive after 10 years.
The life expectancy with MS is on average seven years shorter than for someone without MS, but this can vary considerably between different people with the disease. Some people with a very aggressive disease may die after a relatively short time with the disease, whereas many others live a normal lifespan.
The Impact of Misdiagnosis
As mentioned above, several commonalities between lupus and MS that can contribute to a misdiagnosis:
Since different medications are used to treat lupus and MS, one of the problems with misdiagnosis is that you won’t get the best treatments for your disease. That’s not all, though: Some MS medications can make lupus symptoms worse.
If you have been diagnosed with either lupus or MS, especially if your condition is considered “atypical,” talk to your healthcare provider. Ask about and learn about your diagnosis. If you don’t understand something, ask again. If the diagnosis doesn’t seem to fit, be sure to mention that at your next appointment.
Make sure you are seeing a specialist who is anexpert at treating either lupusor anMS specialist. You may also want to get a second opinion. Some people are hesitant to request a second opinion, but not only does thisnotoffend your healthcare provider, but it’s also expected when people are coping with a serious medical condition.
You might feel like you are alone in coping with your diagnosis. Many people with MS are hesitant to talk about their condition in public, and people with lupus often find that people say hurtful things when learning of their disease.
There is less understanding about lupus or MS in the population at large relative to many other medical conditions. Many of the symptoms are not visible to others, resulting in “silent suffering.“
Consider joining a support group or an online support community. This can be a good way to meet other people who are coping with some of the same challenges and is often a great way to learn more about your disease and the latest research.
Correction-September 12, 2022: The article was updated to clarify the differences between MS and lupus symptoms.
MS symptoms are mostly similar in men and women, but there are a few differences:Women can sometimes have more inflammatory lesions appear in brain scans than men.Neurodegeneration seems to have a stronger effect on men than women.Men can experience worse cognitive issues, such as memory and decision making.Women’s immune systems see greater benefits from vitamin D supplementation than men.
MS symptoms are mostly similar in men and women, but there are a few differences:
Yes, there are four different types of lupus.
It is possible to die from lupus, or more specifically, from the health problems that it causes like infection, kidney disease, and heart disease. However, people with lupus can live long, healthy lives with the help of professional treatment. This can include the use of non-steroidal inflammatory drugs (NSAIDs), corticosteroids, antimalarial drugs, chemotherapy, immunosuppressive agents, and more.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Magro Checa C, Cohen D, Bollen EL, van Buchem MA, Huizinga TW, Steup-Beekman GM.Demyelinating disease in SLE: is it multiple sclerosis or lupus?.Best Pract Res Clin Rheumatol. 2013;27(3):405–424. doi:10.1016/j.berh.2013.07.010Autoimmune Association.Autoimmune disease list.Autoimmune Association.What is lupus.Autoimmune Association.What is multiple sclerosis.Johns Hopkins Lupus Center.Antiphospholipid antibodies.Hryb JP, Chiganer E, Contentti EC, Di Pace JL, Lessa C, Perassolo MB.Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases.Spinal Cord Ser Cases. 2016;2:16005. doi:10.1038/scsandc.2016.5Wu L, Huang D, Yang Y, Wu W.Combined screening for serum anti-nuclear and anti-aquaporin-4 antibodies improves diagnostic accuracy for distinguishing neuromyelitis optica from multiple sclerosis.Eur Neurol. 2014;72(1-2):103–108. doi:10.1159/000358218Lupus Foundation of America.Treating lupus: A guide.Johns Hopkins Lupus Center.Treating lupus with immunosuppressive medications.National Multiple Sclerosis Society.Treatments and medications.Airas L.Hormonal and gender-related immune changes in multiple sclerosis.Acta Neurol Scand. 2015;132(S199):62–70. doi:10.1111/ane.12433Lupus Foundation of America.What is systemic lupus erythematosus (SLE)?.Lupus Foundation of America.Lupus and skin rashes.Lupus Foundation of America.What is drug-induced lupus?.Lupus Foundation of America.What is neonatal lupus?.Centers for Disease Control and Prevention.Lupus basics.Additional ReadingJuryńczyk M, Craner M, Palace J.Overlapping CNS inflammatory diseases: differentiating features of NMO and MS.J Neurol Neurosurg Psychiatry. 2015;86(1):20–25. doi:10.1136/jnnp-2014-308984Karussis D.The diagnosis of multiple sclerosis and the various related demyelinating syndromes: a critical review.J Autoimmun. 2014;48-49:134–142. doi:10.1016/j.jaut.2014.01.022Lupus Foundation of America.What is lupus?National Multiple Sclerosis Society.What is MS?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Magro Checa C, Cohen D, Bollen EL, van Buchem MA, Huizinga TW, Steup-Beekman GM.Demyelinating disease in SLE: is it multiple sclerosis or lupus?.Best Pract Res Clin Rheumatol. 2013;27(3):405–424. doi:10.1016/j.berh.2013.07.010Autoimmune Association.Autoimmune disease list.Autoimmune Association.What is lupus.Autoimmune Association.What is multiple sclerosis.Johns Hopkins Lupus Center.Antiphospholipid antibodies.Hryb JP, Chiganer E, Contentti EC, Di Pace JL, Lessa C, Perassolo MB.Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases.Spinal Cord Ser Cases. 2016;2:16005. doi:10.1038/scsandc.2016.5Wu L, Huang D, Yang Y, Wu W.Combined screening for serum anti-nuclear and anti-aquaporin-4 antibodies improves diagnostic accuracy for distinguishing neuromyelitis optica from multiple sclerosis.Eur Neurol. 2014;72(1-2):103–108. doi:10.1159/000358218Lupus Foundation of America.Treating lupus: A guide.Johns Hopkins Lupus Center.Treating lupus with immunosuppressive medications.National Multiple Sclerosis Society.Treatments and medications.Airas L.Hormonal and gender-related immune changes in multiple sclerosis.Acta Neurol Scand. 2015;132(S199):62–70. doi:10.1111/ane.12433Lupus Foundation of America.What is systemic lupus erythematosus (SLE)?.Lupus Foundation of America.Lupus and skin rashes.Lupus Foundation of America.What is drug-induced lupus?.Lupus Foundation of America.What is neonatal lupus?.Centers for Disease Control and Prevention.Lupus basics.
Magro Checa C, Cohen D, Bollen EL, van Buchem MA, Huizinga TW, Steup-Beekman GM.Demyelinating disease in SLE: is it multiple sclerosis or lupus?.Best Pract Res Clin Rheumatol. 2013;27(3):405–424. doi:10.1016/j.berh.2013.07.010
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Autoimmune Association.What is lupus.
Autoimmune Association.What is multiple sclerosis.
Johns Hopkins Lupus Center.Antiphospholipid antibodies.
Hryb JP, Chiganer E, Contentti EC, Di Pace JL, Lessa C, Perassolo MB.Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases.Spinal Cord Ser Cases. 2016;2:16005. doi:10.1038/scsandc.2016.5
Wu L, Huang D, Yang Y, Wu W.Combined screening for serum anti-nuclear and anti-aquaporin-4 antibodies improves diagnostic accuracy for distinguishing neuromyelitis optica from multiple sclerosis.Eur Neurol. 2014;72(1-2):103–108. doi:10.1159/000358218
Lupus Foundation of America.Treating lupus: A guide.
Johns Hopkins Lupus Center.Treating lupus with immunosuppressive medications.
National Multiple Sclerosis Society.Treatments and medications.
Airas L.Hormonal and gender-related immune changes in multiple sclerosis.Acta Neurol Scand. 2015;132(S199):62–70. doi:10.1111/ane.12433
Lupus Foundation of America.What is systemic lupus erythematosus (SLE)?.
Lupus Foundation of America.Lupus and skin rashes.
Lupus Foundation of America.What is drug-induced lupus?.
Lupus Foundation of America.What is neonatal lupus?.
Centers for Disease Control and Prevention.Lupus basics.
Juryńczyk M, Craner M, Palace J.Overlapping CNS inflammatory diseases: differentiating features of NMO and MS.J Neurol Neurosurg Psychiatry. 2015;86(1):20–25. doi:10.1136/jnnp-2014-308984Karussis D.The diagnosis of multiple sclerosis and the various related demyelinating syndromes: a critical review.J Autoimmun. 2014;48-49:134–142. doi:10.1016/j.jaut.2014.01.022Lupus Foundation of America.What is lupus?National Multiple Sclerosis Society.What is MS?
Juryńczyk M, Craner M, Palace J.Overlapping CNS inflammatory diseases: differentiating features of NMO and MS.J Neurol Neurosurg Psychiatry. 2015;86(1):20–25. doi:10.1136/jnnp-2014-308984
Karussis D.The diagnosis of multiple sclerosis and the various related demyelinating syndromes: a critical review.J Autoimmun. 2014;48-49:134–142. doi:10.1016/j.jaut.2014.01.022
Lupus Foundation of America.What is lupus?
National Multiple Sclerosis Society.What is MS?
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