With all these vague and confusing symptoms, how will I ever know whether I do have lupus or not?
Diagnosing lupus on the basis of symptoms alone can be a tricky thing even for a physician. However, certain symptoms, such as butterfly rash, joint pains etc may be a pointer towards the disease. There is certainly no clear set of diagnostic criteria for lupus. Often the symptoms are non-specific and occur in other diseases too so they can be quite misleading. It may take months and a lot of patience before the disease is diagnosed even when the patient has been feeling unwell for quite some time.
What are steps have to follow to conform the possibility of lupus?
If you suspect that you might have lupus based on your symptoms do not hesitate to consult your primary health care doctor. You may be referred to several specialists before you are able to be diagnosed correctly. Your doctors will have to rule out other common reasons for your symptoms before considering the possibility of lupus.
Your doctors will take a detailed medical history so be prepared by writing down all your symptoms before any appointment. You will be asked whether your symptoms come and go, whether sunlight triggers these symptoms, whether you have had rashes off and on and whether anyone in your family has been diagnosed with an autoimmune disorder. You will also be asked whether you plan to get pregnant.
A full physical examination will be carried out. Your skin will be checked for rashes or other signs of the disease. The most distinctive sign of lupus is the butterfly rash that resembles a butterfly spread across the face, over the nose bridge and both cheeks. However, this does not occur in all cases of lupus.
The examining doctor will also look for sores in the mouth or nose which may have been present for a while. He will examine your fingers and toes for any discolouration and check for any swollen glands. A general exam will also be carried out to check for any evidence of heart, liver, kidney or joint disease.
What are the preferred tests for diagnosing lupus ?
Based on your medical and family history the doctor may advise some tests.
A urine test which may reveal blood casts and albuminuria if the lupus has affected your kidneys. That however is not diagnostic of lupus itself but rather of kidney disease.
A complete blood test which might reveal a low haemoglobin, a low RBC count, a low platelet count and a low TLC count. The anaemia could be indicative of lupus.
Erythrocytes sedimentation rate or ESR could be raised. This test too is not specific for lupus as it could occur in other conditions as well.
4.Kidney function tests
Kidney function tests such as serum creatinine and blood urea could reveal whether the kidneys have been affected.
5.Liver function tests
Liver function tests may also be done to assess any damage to the liver.
6. Skin biopsy
Skin biopsy which takes a small sample of your skin and examines it under the microscope could definitely help diagnosing lupus.
More importantly, an anti-nuclear antibody (ANA) will reveal whether you have any auto antibodies which would be indicative of an autoimmune disorder. If your test is negative then lupus is ruled out conclusively. If the test is positive other tests specific for lupus may be done.
Further specific immunological tests such as anti SS and anti DS and others may be advised.
A chest X-ray could reveal any inflammation or fluids in the lungs.
A kidney biopsy could also be carried out.
11. Anti phospholipid test
An anti phospholipid test could reveal increased tendency for blood clots .
Symptoms, Signs and Tests
Based on a combination of symptoms, signs and tests a lupus diagnosis might be reached at and treatment started. There is no cure for lupus, but medicines and lifestyle changes can help manage the disease.