autoimmune disease blog

Diagnosing lupus is difficult because the symptoms are varies considerably. It may change over time and overlap with those of many other disorders. For these reasons, the doctor may not initially consider lupus until the signs and symptoms become clearer. Even then, lupus can be challenging to diagnose because nearly all people with lupus experience fluctuations in disease activity. At times the disease may become severe and at other times subside completely.

To diagnose lupus, a doctor should be able to find laboratory or physical evidence of the condition, such as protein in the urine, swelling of joints, fluid around the lungs or heart, or a skin biopsy that shows evidence of the disease. The doctor also will look at a person’s medical history and special tests to rule out other diseases.

For most people, lupus diagnose is not a onetime process. More often than not it is a diagnosis that evolves over time either towards more certainty that a person does or does not meet the criteria for a diagnosis of lupus. So what is the doctor looking for to help determine if someone may have lupus?

1. Malar rash. Butterfly-shaped and fixed red rash over the cheeks
2. Discoid (skin) rash. Red patches of skin associated with plugging and scaling of the hair follicles
3. Photosensitivity. Rash after exposure to sunlight
4. Mucosal ulcers. Small sores that occur in mucosal lining of mouth and nose, usually painless
5. Arthritis. Pain in the joints, along with tenderness, effusion or swelling.
6. Cardio-pulmonary involvement. Inflammation of the delicate tissues covering internal organs such as heart and/or lungs.
7. Neurologic disorder. Psychosis and/or seizures
8. Renal disorder. Excessive protein in the urine, usually detected by routine blood and urine analysis
9. Hematologic (blood) disorder. Low white blood cell count, hemolytic anemia hemolytic anemia or low platelet count
10. Immunologic disorder. Tests on LE cells, anti-DNA and anti-SM antibodies
11. Antinuclear antibodies (ANA). When found in the blood and the patient is not taking drugs, it is known to cause a positive test for lupus in most cases, but is not necessarily conclusive

Laboratory tests
Lupus diagnose also need laboratory test, the doctor may order blood and urine tests to determine your diagnosis, including:

• Erythrocyte sedimentation rate. The sedimentation rate of erythrocyte isn’t specific for any one disease, but it may be increased if someone has lupus disease, another inflammatory condition or an infection. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease, such as lupus.
• Complete blood count. This test measures the number of red blood cells, white blood cells and platelets as well as the amount of hemoglobin. A low white blood cell or platelet count and low amount of hemoglobin (anemia) may occur in lupus as well.
• Antinuclear antibody (ANA) test. A positive ANA doesn’t always mean that you have lupus. ANA levels may indicate that you have an infection or if you’re taking certain medications. A positive test for the presence of these antibodies indicates a stimulated immune system, which is common in lupus and other autoimmune diseases. If the test has positive result, the doctor may advise more-specific antibody testing.
• Kidney and liver assessment. Because lupus can affect these organs, blood tests can assess how well your kidneys and liver are functioning.
• Urinalysis. An examination of a urine sample may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys.
• Chest X-ray. An image of chest may reveal abnormal pattern that suggest inflammation in your lungs.