Lupus diagnosis method includes physical exams, various tests, and additional procedures
Lupus is a complex autoimmune disorder that attacks healthy tissue throughout the body, and its diagnosis can be challenging due to its variable presentation. Here's a breakdown of the steps doctors take to diagnose lupus.
The diagnostic process begins with a thorough review of a person's medical history and symptoms. Notable symptoms include unexplained joint pain, fatigue, skin rashes (such as the butterfly or malar rash), photosensitivity, oral ulcers, and hair loss.
A physical exam is often conducted during this process, checking for characteristic signs like discoid lupus lesions, malar rash, and other systemic symptoms.
Laboratory tests play a crucial role in the diagnosis. The main screening test is the antinuclear antibody (ANA) test, which detects antibodies against cell nuclei. While this test is highly sensitive for lupus, it is not specific, so further antibody panels are done if positive. These tests include those for anti-dsDNA, anti-Smith antibodies, and others that are more specific to lupus.
Inflammatory markers, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are also measured to detect inflammation. Other blood tests are conducted to check blood counts, kidney and liver function, and complement levels indicating immune activity.
Skin biopsies may be performed when lupus-related skin changes are present to confirm the diagnosis via histology. Imaging studies, such as MRI, ultrasound, CT, or PET scans, may also be used to detect organ inflammation or damage, especially when internal organs are involved.
People with certain ethnic backgrounds, such as Native American, Hispanic, African, Asian, Pacific Islander, or Native Hawaiian, may have a higher risk of developing lupus. However, the exact cause of lupus remains unknown, and scientists have not linked a single gene to its development.
Diagnosing lupus requires a positive ANA test as an entry point, followed by a weighted set of clinical and immunological criteria to establish the diagnosis, according to the 2019 EULAR/ACR criteria. The 11 criteria for lupus include malar rash, discoid rash, oral ulcers, photosensitivity, arthritis, serositis, renal disorder, neurologic disorder, hematologic disorder, antinuclear antibodies, and immunologic disorders.
It's important to note that no single test can confirm lupus, and a doctor needs to go through a variety of steps and tests to determine whether a person has the condition. Blood and urine tests can help rule out other possible causes of symptoms, but there is no single biomarker or other indicator in blood or urine that points to lupus.
Treatment for lupus focuses on preventing or slowing organ damage, managing symptoms, improving a person's quality of life, and maintaining the lowest level of disease activity or complete remission. This primarily consists of several medications, and people with lupus should speak with a healthcare professional about their treatment options and any potential side effects from medications.
Research into complementary treatments for lupus is limited and inconclusive. Doctors may prescribe other medications to treat or prevent complications of lupus or side effects of the medications that treat lupus.
If you notice potential lupus symptoms that are interfering with your daily life, consider consulting a doctor for further evaluation and appropriate treatment.
