Have you ever noticed swollen lymph nodes when you have a cold? Those small, bean-shaped structures are an important part of your immune system, working like filters to keep you healthy. But what if your lymph nodes are always swollen, especially if you have lupus?

In this article, we’ll explore some of the reasons why swollen lymph nodes occur in people with lupus and outline some other possible causes of enlarged lymph nodes. We’ll also provide some ideas on what you should do if you experience this common symptom.

Can Lupus Cause Swollen Lymph Nodes?

When you have lupus, it’s not uncommon to experience swollen lymph nodes — also known as lymphadenopathy. This symptom of lupus is typical in systemic lupus erythematosus (SLE), the most common form of lupus. But how and why does this symptom happen?

Lymph nodes are an important part of your immune system. They serve as hubs within the lymphatic system where immune cells help fight off infections by filtering out harmful substances from your body. Researchers are still working to understand why people with lupus often have swollen lymph nodes, but it may be related to the autoimmune nature of lupus.

Lupus is an autoimmune disease that causes your immune system to shift into overdrive and mistakenly attack healthy tissues. This process triggers inflammation, and your lymph nodes can swell when your immune system tries to deal with what your body thinks is a threat. Because lupus causes inflammation, swollen lymph nodes are often a sign that your lupus is flaring up. A MyLupusTeam member said of swollen lymph nodes, “I get them when I’m flaring or coming down with something.”

Your lymph nodes may swell for various other reasons, including infections or other health issues. As one MyLupusTeam member wisely put it, “I would notify your doc. Swollen lymph nodes can be nothing to worry about, or they can be big things to worry about.”

If you notice swollen lymph nodes or any new symptoms, it’s always best to talk with your healthcare provider. They can help you determine the cause of the swelling and give you strategies to treat your symptoms.

Places You Might Notice Swollen Lymph Nodes

Swollen lymph nodes can show up in different parts of your body and may feel like hard, tender lumps or bumps — under your armpit, on your neck, or in another area altogether. Swollen lymph nodes can either be localized (a few swollen nodes found only in one area) or diffuse/generalized (multiple swollen nodes found throughout the body).

A few of the common parts of the body where you may notice enlargement of lymph nodes include:

• Head
• Neck
• Throat
• Underarms
• Groin

Swollen lymph nodes associated with lupus can vary from person to person. Not everyone may experience them in the same way or in the same places. If you have concerns about swollen lymph nodes or notice any unusual changes in your body, talk with your healthcare provider.

Can Lupus Medications Cause Swollen Lymph Nodes?

Some medications can cause lymph node swelling as a side effect, but the primary treatments used for lupus are not known to cause this specific side effect. Apart from known side effects of a medication, your body can also react negatively to certain drugs.

One example of these negative reactions to medication is called drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. DRESS syndrome is a potentially life-threatening reaction to a medication, which can cause:

• Fever
• Rash
• Swollen lymph nodes
• Blood cell changes
• Problems with multiple organs, such as your liver, kidneys, lungs, or heart

Some of the medications that have been connected to DRESS syndrome include:

• Antiepileptics
• Antibiotics
• Antituberculosis drugs
• Nonsteroidal anti-inflammatory agents (NSAIDs), such as ibuprofen, naproxen, and aspirin

DRESS syndrome may be more common in people who have a weakened immune system. Many of the drugs used to treat lupus are immunosuppressants, so taking these medications may increase your risk of DRESS syndrome. Be sure to talk with your doctor if you experience swollen lymph nodes along with a fever or rash soon after taking a medication.

Other Potential Causes of Swollen Lymph Nodes

There are several reasons you may experience swollen lymph nodes outside of lupus-related causes. Your healthcare specialist can help you understand if your swollen lymph nodes are related to lupus or something else.

Infections

When you have an infection, your body’s immune system makes more white blood cells. These cells can build up in your lymph nodes and cause them to swell. Most cases of swollen lymph nodes are due to infection. Both viral infections and bacterial infections can cause this common symptom. This swelling is a sign that your immune system is working to fight the infection. This explains why you often have swollen lymph nodes with a sore throat. After you recover from an infection, your lymph nodes may take a couple of weeks — or even months — to return to their normal size.

Vaccinations

Because vaccines work by stimulating your immune system, lymph node swelling can happen as a side effect of vaccination. The mRNA COVID-19 vaccine is one of the vaccines known to cause lymph node swelling in the armpits. Similar to lymph node swelling during infection, this swelling is a good sign and indicates that the vaccine is working.

Cancer

Lymphoma is cancer in the lymphatic system. This can cause lymph node swelling if cancerous cells block the flow of fluid through your lymph nodes. There are many types of lymphoma, the two main types being Hodgkin lymphoma and non-Hodgkin lymphoma. People with lupus have an increased risk of developing some cancers, including non-Hodgkin lymphoma and leukemia. Plus, people with Sjögren’s disease, which is a common coexisting condition with lupus, have an even greater risk of developing lymphoma. In addition, some immunosuppressants used to treat lupus may increase a person’s risk of developing lymphoma.

Other Diseases

Several other diseases may cause swelling of the lymph nodes. These include:

• Other autoimmune diseases — For example, rheumatoid arthritis may cause lymph node swelling.
• Kikuchi-Fujimoto disease — This rare inflammatory disease causes lymph node swelling. Other symptoms of Kikuchi disease include night sweats, weight loss, fatigue, and fever.
• Sarcoidosis — This autoimmune disorder causes your body to form granulomas (collections of immune cells) throughout your body, including the lymph nodes.
• Castleman disease — In people living with this disease, the cells in the lymph nodes overgrow, causing the nodes to swell.

When To See a Doctor

While you should always talk with your doctor if you notice any new or concerning symptoms, you should definitely see a doctor for swollen lymph nodes if you experience any of the following:

• The swelling doesn’t go away after a few weeks, or if the swelling gets worse over time
• Your lymph nodes are red and painful to touch
• You’re also experiencing other symptoms such as a fever, night sweats, or unexplained weight loss
• Your lymph nodes are hard or irregularly shaped
• Nodes in a child are larger than 1 centimeter in diameter

Diagnosis and Treatment of Swollen Lymph Nodes

Your doctor will use your medical history, a physical exam, and the results of several tests to determine the cause of the swelling in your lymph nodes. Some tests they may use include:

• Blood tests — A complete blood count may be used to measure the number of each blood cell type in your blood.
• Imaging tests — X-rays or CT scans may be used to look for swollen lymph nodes in other areas, such as your chest.
• Biopsy — Your doctor may take a tissue sample from your lymph node to look at it under a microscope to see what is causing the swelling.

The treatment for swollen lymph nodes depends on what’s causing the swelling. If your doctor decides that no treatment is needed, you can manage any uncomfortable symptoms of swollen lymph nodes at home using over-the-counter pain relievers and warm compresses.

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