As signs and symptoms vary considerably from person to person, there
is no single diagnostic test that can confirm lupus. In addition, signs
and symptoms tend to change
over time and are similar to those of other disorders and diseases.
These fluctuations in disease activity make lupus extremely challenging
to diagnose.
Currently, doctors use guidelines established by The American College
of Rheumatology (ACR) to diagnose lupus (SLE). The guidelines focus on
eleven abnormalities that,
when combined, suggest that the patient has lupus. To be classified as having SLE, a patient must meet 4 of the following 11 symptoms at any time since the onset of the
disease:
- Serositis - inflammation of the membrane around the lungs (pleuritis) or the heart (pericarditis)
- Mucosal ulcers - small sores found in the lining of the mouth and nose
- Arthritis - nonerosive arthritis (tenderness, swelling, pain) of two or more peripheral joints
- Photosensitivity - skin rash or other symptoms caused by exposure to ultraviolet light
- Blood disorder - hemolytic anemia (low red blood cell count), leucopenia and lymphopenia (low white blood cell count), or thrombocytopenia (low platelet count)
- Renal (kidney) disorder - high protein count in urine
- Antinuclear antibody test positive
- Immunologic disorder - positives on anti-Smith, anti-ds DNA, antiphospholipid antibody tests.
- Neurologic disorder - seizures or psychosis
- Malar rash - rash on cheeks
- Discoid rash - red, scaly patches on skin that cause scarring
In addition to the above tests, doctors will often conduct a variety of blood tests such as:
- Complete blood count (CBC) to detect anemia, low platelet count, and low white blood cell count
- Erythrocyte sedimentation rate (ESR) to determine the rate at which red blood cells settle to the bottom of a tube in an hour. Rates faster than normal may indicate lupus or another systemic disease, inflammatory condition, or infection.
- Kidney and liver assessment to look for certain enzymes and albumin
- Urinalysis to measure protein levels or red blood cells in the urine
- Syphilis test to determine if anti-phospholipid antibodies are in the blood.
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