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 what you should do if your lymph nodes are swollen. We will also discuss some of the treatment options your doctor might offer you.

Can Lupus Cause Swollen Lymph Nodes?

The most common form of lupus is called systemic lupus erythematosus (SLE). When you have lupus, it's not uncommon to experience swollen lymph nodes — also known as lymphadenopathy. 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 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. 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 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, it’s always best to talk with your doctor. 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. 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 you may notice swollen lymph nodes include:

• Head
• Neck
• Throat
• Underarms
• Groin

Less common places such as your stomach, chest, or deeper in your body

Swollen lymph nodes in lupus can vary from person to person, and 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 health care provider.

Can Lupus Medications Cause Swollen Lymph Nodes?

Some medications can cause lymph node swelling as a side effect, but none of the main medications used to treat lupus are 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 that 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 known to cause DRESS syndrome include:

• Seizure medications — Phenytoin, carbamazepine, and primidone
• Some blood pressure medications — Captopril, atenolol, and hydralazine
• Heart medications — Quinidine, for example
• Allopurinol — A medication used to treat gout
• Some medications used to treat arthritis — Sulindac and gold therapy
• Antimicrobial medications — For example, penicillin-type antibiotics, cephalosporin-type antibiotics, pyrimethamine, and trimethoprim/sulfamethoxazole

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

Apart from lupus-related reasons, there are several reasons why you may experience swollen lymph nodes. Your doctor 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. 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 is a common side effect of vaccination. The COVID-19 messenger RNA 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 and 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 lymphoma. Furthermore, people with Sjögren’s syndrome, which is a common finding in those with lupus, have an even greater risk of developing lymphoma. In addition, several immunosuppressants used to treat lupus, such as azathioprine (Imuran), mycophenolate mofetil (CellCept), and cyclophosphamide (Cytoxan), 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 or HIV infection may cause lymph node swelling.
• Kikuchi 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:

• 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 are also experiencing other symptoms such as a fever, night sweats, or unexplained weight loss
• The swelling is larger than the length of a staple (1 centimeter) in diameter
• Your lymph nodes are hard or irregularly shaped

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 of the 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 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 is causing the swelling. If your doctor decides that no treatment is needed, you can manage the symptoms of swollen lymph nodes at home using over-the-counter pain relievers and warm compresses.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you had swollen lymph nodes? Share your experience in the comments below, or start a conversation by posting on your Activities page.