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Diagnosis

Lupus is a type of self-allergy, a disease of many manifestations and each patients profile or list of symptoms may be different. The specialist may need to investigate any of:

  • Skin
  • Blood
  • Fatigue
  • Joints
  • Heart
  • Fever
  • Kidneys
  • Lungs
  • Brain
  • Swollen glands
  • Nervous system
  • Weight changes

Several manifestations such as those listed below may suggest clinical evidence of a multi-symptom disease:

SKIN Rashes, Mouth Ulcers, Hair loss
JOINTS Pain, redness, swelling
KIDNEYS Abnormal Urinanalysis
LINING MEMBRANES Pleurisy, Pericarditis, Peritonitis
BLOOD Haemolytic Anaemia, Leukopenia
LUNGS Shortness of breath, cough
NERVOUS SYSTEM Convulsions, psychosis

Image of doctor and x-rays

In arriving at a firm diagnosis the physician will normally expect at least four of a list of 11 internationally accepted conditions to be present (either currently or at any time since the onset of the illness) The American Rheumatism Association established the of 11 abnormalities which are;

 

 

  1. MALAR RASH – Fixed red rash over the cheeks
  2. DISCOID RASH – Red patches of skin associated with scaling and plugging of the hair follicles
  3. PHOTOSENSITIVITY – Rash after exposure to sunlight
  4. ORAL ULCERS – Small sores that occur in mucosal lining of mouth and nose
  5. SEROSITIS – Inflammation of the delicate tissues covering internal organs, and abdominal pain
  6. ARTHRITIS – Very common in lupus, usually pain in the joints and tendons
  7. RENAL DISORDERS – Usually detected by routine blood and urine analysis
  8. NEUROLOGICAL DISORDERS – Seizures or psychosis, balance problems
  9. HAEMOTOLOGICAL DISORDER – Haemolytic Anaemia, Leukopenia, Thrombocytopenia
  10. IMMUNOLOGIC DISORDER – Tests anti-DNA, anti-SM antibodies, antiphospholipid antibodies
  11. ANTI-NUCLEAR ANTIBODY (ANA TEST) – 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 it is not necessarily conclusive

Diagnosis of lupus is never straightforward, the real cause is still far from clear and the symptoms can vary widely from day to day in any one patient.

Diagnosis is usually achieved through a rheumatologist but other specialists may also be involved, eg dermatologists, kidney specialists, cardiologists, obstetricians.

You can watch some people with lupus talking about their experiences of getting diagnosed in this video:

 

 

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