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Diagnosing Lupus |
Diagnosing lupus can be difficult. There is no single set of symptoms that is specific for lupus. Many of the lupus symptoms mimic other illnesses, are sometimes vague and may come and go. Currently, there is no single laboratory test that can determine if a person has lupus or not.
Diagnosis is usually made by a careful review of the patient’s entire medical history coupled with an analysis of the results obtained in normal routine laboratory tests and some specialized tests related to immune status.
Eleven criteria for the diagnosis of lupus were established by the American College of Rheumatology. A person must have four or more of these symptoms for a lupus diagnosis. The symptoms do not have to occur at the same time.
Criteria used for the diagnosis of Lupus Erythematosus:
* Anti-Nuclear Antibody (ANA): Positive test for anti-nuclear antibodies in the absence of drugs known to induce it.
* Arthritis: Arthritic inflammation in two or more joints, not accompanied by marked deformity.
* Discoid Rash: Red, raised patches on any part of the body.
* Hematological Disorder: Low hemoglobin (hemolytic anemia); low white blood cell count (leukopenia); low lymphocyte count (lymphopenia); or low platelet count (thrombocytopenia). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.
* Immunologic Disorder: Commonly employed tests that reflect the immunologic disorder of lupus include: positive LE prep test, positive anti-DNA test, positive anti-Sm test, positive antiphospholipid antibodies or false positive syphilis test (VDRL).
* Malar Rash: A redness or rash on the face that may appear in a butterfly configuration on the cheeks.
* Neurologic Disorder: Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances that are known to cause such effects.
* Oral Ulcers: Frequent ulcers in the nose or mouth, usually painless.
* Photosensitivity: Reaction to sunlight, resulting in the development of, or increase in, skin rash.
* Renal (Kidney) Disorder: Detected by excessive protein and/or cellular casts in the urine.
* Serositis: Pleuritis (pleurisy), inflammation of the membrane that lines the inside of the chest cavity surrounding the lungs and pericarditis, inflammation of the sac or lining surrounding the heart.
