Family history of lupus (SLE): what it means for your risk

The NHS describes lupus, or systemic lupus erythematosus, as a long-term condition that causes joint pain, skin rashes and tiredness. There is no cure, but symptoms can improve if treatment starts early. Because it can affect many parts of the body and mimic other illnesses, it is not always quick to diagnose.

Doctors ask about family history of lupus, and of other autoimmune conditions, because these appear to cluster in some families. Lupus UK says people with a history of the disease in their family may be at a higher risk of developing it. That is a statement about tendency, not certainty.

Lupus UK says the cause of lupus is not certain, but research suggests genes, hormones and infections including viruses may play a role, in a complex interaction between the body and its environment. NHS inform likewise says it is thought that a combination of genetic and environmental factors may trigger lupus in certain people.

The NHS lists possible causes or triggers as viral infection, certain medicines, sunlight, puberty, childbirth and menopause. NHS inform adds that some medications can also cause lupus-like side effects. Taken together, this suggests that inheriting a tendency is not enough on its own: something else seems to switch the condition on.

Lupus UK points out that there is no genetic test available for lupus, so a relative cannot be tested to find out whether they will develop it.

The NHS says more women than men get lupus, and that it is more common in women with an African, Caribbean, Asian or Chinese background. NHS inform says around 90% of cases occur in women, and that the condition is most common in women of childbearing age, between 15 and 50, though it can affect people of other ages.

Lupus UK explains that why it mostly affects women is still not fully understood, with broad explanations that include the presence of two X chromosomes in women and the role of hormonal activity as a trigger. It adds that lupus is found all over the world.

The NHS says there are lots of possible symptoms. The main ones include joint and muscle pain, extreme tiredness that does not go away however much you rest, and rashes that usually come on after being in the sun, often over the nose and cheeks.

• Headaches, mouth ulcers and a high temperature.

• Hair loss and weight loss.

• Swollen glands, usually in the neck, armpits or groin.

• Depression and anxiety.

• Chest or tummy pain.

• Fingers and toes changing colour in the cold, anxiety or stress (Raynaud's).

The NHS explains that lupus often flares up, with symptoms getting worse for a few weeks or sometimes longer, and then settles down into remission. The reason for flares or remissions is not known, and some people notice no difference at all.

Severity ranges widely. The NHS describes mild lupus as joint and skin problems and tiredness, moderate lupus as inflammation of other parts of the skin and body including the lungs, heart and kidneys, and severe lupus as inflammation causing severe, potentially life-threatening damage to the heart, lungs, brain or kidneys.

The NHS says lupus is not always easy to diagnose because the symptoms can be similar to other conditions. A GP will usually do blood tests, and may diagnose lupus if the tests show high levels of a certain type of antibody and you also have the typical symptoms.

You might be referred for X-rays and scans of the heart, kidneys and other organs if the doctor thinks they might be affected. If lupus is confirmed, the NHS says you will be advised to have regular checks such as blood tests for anaemia and urine tests for kidney problems.

A family history alone does not lead to a diagnosis. It simply makes it more reasonable to take persistent symptoms seriously and to mention the history when you see your GP.

According to the NHS, treatment can include anti-inflammatory medicines such as ibuprofen, hydroxychloroquine for fatigue and skin and joint problems, and steroid tablets, injections and creams for kidney inflammation and rashes. Immunosuppressant or biological medicines are sometimes used for severe lupus.

It also suggests using high-factor sunscreen of at least factor 50 and a hat in the sun, pacing yourself to avoid getting too tired, staying active even on a bad day, using relaxation techniques because stress can make symptoms worse, eating a healthy balanced diet, and not smoking because smoking makes lupus worse.

The NHS also advises seeing a doctor before trying to get pregnant, because lupus can cause complications in pregnancy and medicines may need to be reviewed.