DIAGNOSIS:
L U P U S


  • For some people, lupus is a mild disease affecting only a few body organs and yet for others, it can cause serious and even life-threatening problems, showing just how very individual an illness lupus is in each and every patient with it!.
  • Lupus can affect every organ, including the largest, the skin, as well as all the joints, the central nervous system, blood, and all other bodily systems involving the connective tissues which become inflamed during a lupus flare.
  • Lupus is chronic and also is an autoimmune disease in which the body's immune system, instead of serving its normal and protective function, forms antibodies that attack its' own healthy tissues and organs, becoming disordered, disorganized and overactive and during the process creating damage to the tissues involved.
  • If not medically controlled and treated, systemic lupus can be life-threatening during a flare involving the major organs such as the heart, lungs, kidneys and CNS, creating damage that can not be undone if not diagnosed and treated.

The DIAGNOSIS OF LUPUS
May Be Established Using A
5 Step Protocol

  1. Complete physical examination: Detailing a thorough physical examination.

  2. Putting Patients through a battery of Laboratory Tests:

    • Complete blood count
    • Erythrocyte sedimentation rate (ESR): an elevated sed rate is an indicator of inflammation in the body
    • Urinalysis
    • Blood chemistries
    • Complement levels: often low in people with lupus, especially during a flare
    • Antinuclear antibody test (ANA) -- positive in most lupus patients, but a positive ANA test can have other causes and it can be negative in lupus dx
    • Other autoantibody tests: anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), anti- La (SSB)
      One or more of these tests may be positive in some people with lupus
    • Syphilis test: may be falsely-positive in some people with lupus
    • Skin or kidney biopsy may be required

  3. Ruling out other autoimmune diseases and/or infections.

  4. Medical history: Obtaining a History may involve time and time is sometimes necessary in order to observe the course of the disease to achieve a lupus diagnosis.

  5. Reviewing all patient symptoms for LUPUS DIAGNOSIS, by using the ACR Criteria which requires the presence of at least 4 of the 11 criteria as decided by the
    A    merican College of Rheumatologists Association, at the time of examination of the patient, by a specialist.


    ACR 11 CRITERIA RE LUPUS DIAGNOSIS

  1. Malar rash (butterfly shaped rash across cheeks and nose)

  2. Discoid rash (usually on the torso and face)

  3. Photosensitivity (extreme reaction to sunlight and/or fluorescent lighting)

  4. Oral ulcers (painless sores in the mouth and/or nose)

  5. Arthritis (non deforming chronic joint pains with likely elevated ESR re labs)

  6. Serositis [pleuritis (lung lining inflamed) or pericarditis (heart involved inflammation)]

  7. Renal disorder (proteinuria or cellular casts in urine, from kidneys)

  8. Neurologic disorder (seizures or psychosis involving CNS)

  9. Hematologic (blood) disorders (hemolytic anemia, leukopenia, lymphopenia or thrombocytopenia)
    a

  10. Immunologic disorder (positive LE cell, anti-double stranded DNA antigen, anti-Smith antigen or the falsely positive results of the VDRL test; and likely a positive Rheumatoid/Rh factor and likely an elevated Erythrocyte Sedimentation Rate/ESR, signifying ongoing inflammation in the patient)

  11. Positive results of fluorescent Anti-Nuclear Antibody; increased ANAs are common;
    ( ANA count can be negative with a diagnosis of lupus -- in fact ANA negative SLE Diagnosis is common.)