Table 3.

Symptoms of pregnancy that can mimic lupus activity

Constitutional	Fatigue that can be debilitating throughout entire pregnancy
Skin	Palmar erythema and a facial blush from increased estrogen
Face	Melasma: ‘Mask of Pregnancy’ A macular, photosensitive hyperpigmented area over cheeks and forehead.
Hair	Increased hair growth and thickness during pregnancy Hair loss in the weeks to months post-partum
Pulmonary	Increased respiratory rate early in pregnancy from progesterone. Dyspnea from enlarging uterus late in pregnancy
Musculoskeletal	Back pain in 2nd and 3rd trimesters ◦ Relaxin loosens SI joint and symphysis pubis ◦ Gravid uterus increases lumbar lordosis Joint effusions: noninflammatory in lower extremities
CNS	Headache can be part of normal pregnancy or associated with hypertension. Seizures occur in eclampsia Cerebral vascular accidents can be caused by preeclampsia or antiphospholipid syndrome.

From A Companion to Rheumatology: Systemic Lupus Erythematosus. Editors Tsokos, Gordon, and Smolen, with permission