1. It Takes a Detective to Diagnose Systemic Lupus
Because its symptoms can mimic many other diseases or conditions, it's not easy to diagnose systemic lupus. Also, different people with lupus have different symptoms. Your doctor has many pieces of a puzzle that he must link together in an attempt to make a proper diagnosis. However, an early diagnosis is important to manage the disease and get people feeling better. The American College of Rheumatology (ACR) developed 11 criteria to help doctors with diagnosis. A doctor might diagnose a person with systemic lupus erythematosus if he has four of the 11 criteria.
2. The Initial Examination
Your doctor will probably start with a medical history, followed by a physical exam and a blood test to screen for a positive anti-nuclear antibody (ANA), which is one of the 11 criteria. A positive ANA is present in 95 percent of people with lupus, but having a positive ANA is not the final word on a lupus diagnosis. Another blood test that may help diagnosis is a false positive syphilis test, which may indicate the presence of a particular antibody. If a doctor suspects systemic lupus, he will perform other tests to try to rule out or confirm the diagnosis.
3. Lupus Skin Problems
Lupus and rash problems are three of the 11 criteria set by the ACR. A malar rash, also known as butterfly rash, covers the bridge of the nose and cheeks. A discoid rash appears as raised, scaly patches on the skin. And a sun-related rash can occur with systemic lupus with sun exposure. A physical exam and medical history will reveal if you've ever had any of the three rashes.
4. Disorders Account for Four of the Criteria
Your doctor may want to check your urine for a renal (kidney) disorder. Another symptom can be a neurological disorder, such as seizures. Your doctor may do further blood tests to rule out low red, white or platelet counts that are indicative of a hematologic disorder. Finally, an immunologic disorder can be a symptom of systemic lupus. The doctor can detect this by conducting blood tests.
5. The Other Three Criteria
Mouth sores are possible criteria, but oddly, they are not usually painful. Having two or more joints that are painful and swell is one of the criteria. The last criterion for systemic lupus is perhaps the most life-threatening. Your doctor may want to conduct an electrocardiogram (ECG) or perform a chest X-ray to see if the linings of the heart or lungs have any swelling.
