One Patient's Positive Perspectives

Diagnosis and Treatment of Lupus:  There is no single laboratory test that can decide whether a person has lupus. Diagnosing lupus involves analyzing the results of several lab tests, a review of the person’s entire medical history, and the history of close family members.  When I was finally diagnosed with Lupus, I had demonstrated 7 of the 11 diagnostic criteria, a positive blood test for ANA and rheumatoid arthritis was ruled out as a cause of my symptoms.

Common blood tests to look for Lupus

  • Anti-nuclear antibody test (ANA) looking for autoantibodies in the blood that attack the nucleus of cells
  • Anti-DNA antibody test to look for antibodies that go after cell’s genetic parts
  • Anti-Sm antibody test to look for Sm (ribonucleoprotein inside cell nucleus) antibodies
  • Blood complement find out how many of a certain type of proteins are used up during immune reactions
  • Tests for amounts and types of C3 and C4 complement proteins

“See Lupus Foundation of America website for more detailed information about lab tests used to diagnose lupus.

Diagnostic Tests

Doctors use many sources of information to decide if a person may have lupus.  They look at their medical history, lab tests and current symptoms, reviewed against 11 Lupus diagnostic criteria. If a patient has at least 4 of the 11 criteria, the diagnosis might be lupus, but some of the criteria are more important that others in making the diagnosis.  7 criteria are symptoms, and 4 are found using lab tests.

The ANA lab test helps doctors diagnose lupus, because 95 % of patients with systemic lupus have a positive ANA. Having symptoms of systemic lupus with a negative ANA usually makes the doctor look for another cause for their symptoms than lupus.  Even a positive ANA all by itself is not enough to diagnose lupus.  Other autoimmune conditions and diseases can also have positive ANA tests, such as:

Rheumatoid arthritis
Sjogren’s (show-grens) syndrome
Scleroderma (sklare-a-derm-a)
Infectious diseases such as:
Subacute bacterial endocarditis (SBE)
Autoimmune diseases including:
Autoimmune thyroid disease
Autoimmune liver disease

The 11 Diagnostic Criteria for Lupus

The Lupus Foundation of America website shares the following information about the diagnostic criteria used to look for lupus:

“To help the doctors diagnose lupus, a list of 11 common criteria, or measures, was developed by the American College of Rheumatology (ACR). ACR is a professional association of rheumatologists. These are the doctors who specialize in treating diseases of the joints and muscles, like lupus. If you have at least four of the criteria on the list, either at the present time or at some time in the past, there is a strong chance that you have lupus.

  1. Malar rash – a rash over the cheeks and nose, often in the shape of a butterfly
  2. Discoid rash – a rash that appears as red, raised, disk-shaped patches
  3. Photosensitivity – a reaction to sun or light that causes a skin rash to appear or get worse
  4. Oral ulcers – sores appearing in the mouth
  5. Arthritis – joint pain and swelling of two or more joints in which the bones around the joints do not become destroyed
  6. Serositis – inflammation of the lining around the lungs (pleuritis) or inflammation of the lining around the heart that causes chest pain which is worse with deep breathing (pericarditis)
  7. Kidney disorder – persistent protein or cellular casts in the urine
  8. Neurological disorder – seizures or psychosis
  9. Blood disorder – anemia (low red blood cell count), leukopenia (low white blood cell count), lymphopenia (low level of specific white blood cells), or thrombocytopenia (low platelet count)
  10. Immunologic disorder – abnormal anti-double-stranded DNA or anti-Sm, positive antiphospholipid antibodies
  11. Abnormal antinuclear antibody (ANA)

People with lupus also may experience symptoms that do not appear among the ACR criteria:

  • fever (over 100° F)
  • extreme fatigue
  • hair loss
  • fingers turning white and/or blue when cold (Raynaud’s phenomenon)”

Comments on: "Diagnosis and Treatment of Lupus Fact #7 – No single test for Lupus!" (2)

  1. […] Diagnosis and Treatment of Lupus Fact #7 – No single test for Lupus! […]

  2. […] To read more about this lupus fact, and some of the lab tests used for making a lupus diagnosis, read my last year’s post about lupus diagnostic tests published on May 7, 2012. […]

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