Lupus - Treatments

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Lupus Diagnosis

Most often lupus is evaluated and treated in the doctor's office. Rheumatology is the field of medicine that is dedicated to autoimmune diseases such as lupus. A rheumatologist is an expert in evaluating and treating lupus.

Criteria for diagnosing lupus

The diagnosis of lupus is a clinical one made by observing symptoms. Lab tests provide only a part of the picture. The American College of Rheumatology has designated 11 criteria for classification. Keep in mind that not all patients suspected of having lupus meet these criteria. To be classified as having lupus accordingly, a person must have four or more of these criteria:

  • Malar rash: This is a "butterfly-shaped" red rash over the cheeks below the eyes. It may be a flat or a raised rash.
  • Discoid rash: These are red, raised patches with scaling of the overlying skin. A subgroup of patients have "discoid lupus" with only skin involvement and do not have systemic lupus erythematosus. All patients with discoid lupus should be screened for systemic involvement.
  • Photosensitivity: A rash develops in response to sun exposure. This is not to be confused with heat rash that develops in body folds or moist areas of the body with exposure to heat.
  • Oral ulcers: Painless sores in the nose or mouth need to be observed and documented by a doctor.
  • Arthritis: The arthritis of lupus usually does not cause deformities of the joints. Swelling and tenderness must be present.
  • Serositis: This refers to an inflammation of various "sacs" or membranes that cover the lung, cover the heart, and line the abdomen. Inflammation of these tissues causes severe discomfort in the areas affected.
  • Kidney disease (nephritis): There is persistent loss of protein in the urine, or a microscopic analysis of the urine, demonstrates inflammation of the kidneys. This can be demonstrated when microscopic analysis of urine has a particular cellular element referred to by pathologists as a "cast."
  • Neurological disorder: This can present as seizures or as a primary psychiatric disorder.
  • Blood disorder: Low blood counts of various blood components are known to occur.
  • Immunologic disorder: This requires special laboratory testing for specific markers of disease in lupus. These tests include antibodies to DNA, a nuclear protein (Sm), or phospholipids (which includes the falsely positive test result for syphilis/RPR, cardiolipin antibodies, and lupus anticoagulant). The presence of these and other antibodies that can react with the body's own tissues is why lupus is called an autoimmune disease.
  • Positive antinuclear antibody: A more general marker in the blood for the presence of an autoimmune disease, these "ANA" levels increase with age, thereby somewhat increasing the rate of an incorrectly positive test as a person gets older. The ANA test is most useful when the result is negative, which essentially rules out the diagnosis of SLE, because most people with lupus have a positive ANA test result.
Return to Lupus (Systemic Lupus Erythematosus)

See what others are saying

Comment from: Dee, 65-74 Female (Patient) Published: October 08

Low dose naltrexone for lupus has given me my life back.

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Comment from: Victory, 45-54 Female (Patient) Published: August 18

I am a 52 yr old female who was diagnosed with (SLE) Lupus 6 months ago. I was constantly in pain, hips, elbows, fingers ankles and groin and had fevers, headaches and chills and my hair was falling out in clumps. I became very depressed. I went to several doctors who just gave me antibiotics and antidepressants. I finally searched my symptoms which guided me towards Lupus. I asked my doctor if I could possibly have Lupus...a blood test for ANA antigens was done and I basically had diagnosed myself. I am taking hydroxychloroquine twice a day for treatment. I tried, but cannot take the anti-inflammatory drugs. I still try to live a normal and productive life.

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