How Lupus Is Diagnosed


General Symptoms Present In Lupus

Skin rashes are extremely common in people who are suffering from lupus. A "butterfly" rash can typically occur on the face, and it can be visually disturbing for the person with lupus. It can also be exacerbated from sun exposure. A large majority of people with lupus also report having ulcerations in their mouths. Joint pain is one of the initial indicators of lupus; a formerly active and healthy individual having developed joint pain and malaise a possible pointer towards having lupus.

Photosensitivity, where the skin can blister from sun exposure, is also experienced in people with lupus. Fever and headaches and reporting of migraines can be an ongoing occurrence as a result of having lupus. Inflammation of various organs such as the lungs can become life threatening if not treated. Alopecia – hair loss – can be caused as a result of lupus.

People who have lupus can occasionally expeience what is known as Raynaud's phenomenon – blood flow is restricted to the fingers – causing numbness and cold; then there is a sudden rush of hot blood to the fingers causing extreme pain.

Insomnia can be a result of having lupus, and also a lot of patients with lupus report having depression. Lupus can also cause problems such as inflated kidneys, and a consequent adverse action in kidney function, leading to the retention of toxins in the body. This can cause the appearance of blood in the urine, swelling of the feet and ankles and dysuria. SLE can also cause the enlargement of glands. The possible multi-system effects of lupus are:

Disorders Within The Body Caused By Lupus

Endocrine disorders: thyroid problems, glucose intolerance
Respiratory disorders: pleurisy, pneumonitis, interstitial fibrosis
Gastrointestinal disorders: lack of appetite, nausea, abdominal pain, diarrhea
Musculoskeletal disorders: arthritis type symptoms, joint swelling, morning stiffness
Sensory issues: conjunctivitis, photophobia, retinal vasculitis with transient blindness, cotton-wool spots on retina
Neurological: seizures, depression, psychosis, neuropathies, potential complications including stroke, organic brain syndrome – memory loss, intellectual impairment, personality changes, disorientation
Cardiovascular disorders: pericarditis, myocarditis, endocarditis, vasculitis, venous or arterial thrombosis
Blood system: anemia, leukopenia
Reproductive system disorders: fetal loss, pregnancy induced hypertension, edema
Metabolic processes: low grade fever, malaise, unexplained weight loss
Other symptoms include potential skin disorders and kidney disorders.

Clinical Diagnosis of Lupus

The diagnostic process of lupus is complex, as the condition involves multiple affected systems. A diagnosis is made upon a patient's personal clinical history, physical assessment and diagnostic tests.

These diagnostic tests include:

Anti-DNA antibody testing – this can provide the most accurate diagnosis of the disease (it was found to be highly accurate in one study); however it indicates any form of connective tissue disease. What distinguishes a SLE diagnosis is the presence of other clinical manifestations of SLE. When a patient has two or more clinical manifestations of SLE, and elevated Anti-DNA antibodies, a diagnosis of systemic lupus erythematosus is confirmed.

Other laboratory indicators can be tested, and these include:

ESR (erythrocyte sedimentation rate) is typically elevated – this test has been used for many years to indicate inflammation is present within the body. It is a simple and straightforward test.

Serum complement levels – these are done to measure the activity of certain proteins moving through the blood, and indicate inflammatory processes that are associated with the immune system.

CBC (complete blood cell count) abnormalities include moderate to severe anemia, leukopenia and lymphocytopenia and possible thrombocytopenia if there is lupus present.

Urinalysis shows mild proteinuria, hematuria, and blood cell casts during exacerbation of the disease when the kidneys are involved. Renal function tests include serum creatinine and blood urea nitrogen is also evaluated.

Kidney biopsies may be performed to determine the extent of possible lesions.

A rarer subtype of lupus, that co-exists with lupus is Bullous Systemic Lupus Erythematosus – it is a disease where autoantibodies attack the subdermal layer of the skin and cause skin deformities to type VII collagen resulting in bullous dermatoses (lumps) under the skin. Its presentation is similar to other types of bullous dermatoses – including dermatitis herpetiformis (DH) and epidermolysis bolosa acquisita (EBA). The diagnosis of BSLE is made possible because of its co-existence with SLE.

In addition to the physically debilitating symptoms of lupus, it effects other general areas of a patient's life, including absenteeism from work, reducing overall education opportunities, lower rates of employment and greater overall work related disabilities. This has a significant negative economic impact on sufferers of lupus.

Early diagnosis and treatment of lupus helps reduce the negative economic impacts of patients with the condition, and appropriate treatment protocols help to alleviate painful symptoms. Thereafter diagnosis and treatment are essential for a better overall quality of life for people with lupus.

Clinical diagnosis includes the taking of the client's medical history and a physical examination and consideration of any of the above symptoms that is caused by lupus.