How is lupus diagnosed? : Johns Hopkins Lupus Center

Because lupus can produce a variety show of symptoms in different individuals, it may take some time for a doctor to actually make the diagnosis. Often a doctor will say that lupus might be present, but that the current symptoms are insufficient to signify a firm diagnosis. In this event, s/he will probably monitor the patient ’ sulfur symptoms, signs, and lab tests closely over time and have him/her recurrence for regular visits .
No unmarried detect qualifies an individual as having SLE. rather, the American College of Rheumatology ( ACR ) has devised sealed classification criteria, and four or more of these criteria must be present for a categorization of lupus. [ The term “ classification ” is not synonymous with “ diagnosis. ” “ Classification ” means that reasonable certainty exists for the diagnosis of lupus for research purposes. ] Although, these criteria are presently being updated, they are believed to be approximately 90 % effective. The ACR criteria include cheekbone rash ; discoid foolhardy ; photosensitivity ( development of a rash after sun exposure ) ; oral or nasal consonant ulcers ; arthritis of multiple joints ; serositis : ( inflammation of the line around the lungs or heart ) ; kidney disease indicated by protein or casts in the urine ; neurological disorders such as seizures and psychosis ; and blood disorders such as hemolytic anemia, leukopenia, and lymphocytopenia. other signs that are common but not included in the categorization criteria are hair personnel casualty or break, specially around the brow, and Raynaud ’ randomness Phenomenon, a two- or three-color change of the fingertips upon cold photograph.

Although no one symptom qualifies person as having lupus, certain clinical techniques can be used to narrow down the diagnosis. For exemplar, a trial for antinuclear antibodies ( ANAs ) in the blood is probably the first instrument a doctor will use. A positive ANA quiz does not inevitably mean that person has lupus ; in fact, one out of five normal women has a convinced ANA. however, a negative ANA test greatly reduces the intuition.

Disease indices

other sets of criteria, known as disease activity indices, exist for the monitor of lupus. These forms allow a doctor examining a affected role to check for the improvement or worsen of the disease. These forms include the BILAG ( british Isles Lupus Assessment Group Index ), SLEDAI ( Systemic Lupus Erythematosus Disease Activity Index ), SLAM ( Systemic Lupus Activity Measure ), ECLAM ( european Consensus Lupus Activity Measurement ), and the Lupus Activity Index ( LAI ). sometimes these indices will show no signs of lupus, even when the patient feels badly. This is because some of the problems that occur in lupus, such as chronic fatigue duty and trouble, are not tracked by the indices. alternatively, these symptoms represent a coincide problem called fibromyalgia.

Other similar conditions

Since other diseases and conditions appear alike to lupus, adhesiveness to classification can greatly contribute to an accurate diagnosis. however, the absence of four of these criteria does not necessarily exclude the possibility of lupus. When a doctor makes the diagnosis of SLE, s/he must exclude the possibility of conditions with comparable symptoms, including arthritic arthritis, systemic sclerosis ( scleroderma ), vasculitis, dermatomyositis and arthritis caused by a drug or virus .


  • Salmon, Jane E., and Robert P. Kimberly. “Systemic Lupus Erythematosus.” Hospital for Special Surgery Manual of Rheumatology and Outpatient Orthopedic Disorders: Diagnosis and Therapy. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2006. 221-38.
  • Schur, Peter H. “General Symptomology.” The Clinical Management of Systemic Lupus Erythematosus. Ed. Peter H. Schur. 2nd ed. Philadelphia: Lippincott-Raven, 1996. 9-16.
  • Wallace, Daniel J. The Lupus Book: A Guide for Patients and Their Families. 3rd ed. New York: Oxford University Press, 2005. 259.
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