DIAGNOSIS
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.
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