How to Diagnose Lupus – 15 Steps With Pictures

Lupus affects approximately 1.5 million Americans, but since its symptoms often masquerade as signs of other illnesses, the condition can be difficult to diagnose. Here are a few of the biggest warning signs of lupus, however, as well as the different tests that doctors might use to detect and officially diagnose the illness.

 

Part 1 of 2: Symptoms and Warning Signs

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    Be aware of the three primary types of lupus. When people refer to lupus, they usually refer to Systemic Lupus Erythematosus (SLE). This type of lupus affects your skin and your organs, especially your kidneys, lungs, and heart. There are other types, of lupus, though, including cutaneous lupus erythematosus and drug-induced lupus.[1]

    • Cutaneous lupus erythematosus only affects the skin and does not threaten the other organs of your body. It rarely develops into SLE.
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    • Drug-induced lupus can affect the skin and your interior organs, but it is induced by the use of certain medications and usually goes away once those medications are out of the patient’s system. The symptoms associated with this form of lupus are typically rather mild, too.
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    Check your face for a butterfly rash. An average of 30 percent of lupus patients develop a characteristic rash over the face often said to look like a butterfly or a wolf bite.[2] The rash spans across the cheeks and nose, often flaring out over the entirety of the cheeks and occasionally covering a portion of skin near the eyes.

    • Also check for discoid rashes around your face, scalp, and neck. These rashes show up as red, raised patches, and they can be so severe that they often leaves scars even after you get rid of them.
    • Pay special attention to rashes that are triggered or worsened by sunlight. Sensitivity to ultraviolet light, whether natural or artificial, can trigger sores on sun-exposed parts of the body and may worse a butterfly rash on your face. This rash is more severe and develops faster than a usual sunburn would.
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    Note any mouth or nasal sores. If you frequently get sores on the roof of your mouth, along the side of your mouth, on your gums, or inside your nose, this could be another warning sign.

    • In particular, this is often the case if these sores are not actually “sore.” In most cases, mouth and nasal sores associated with lupus are pain-free.
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    Look for symptoms of inflammation. Inflammation of the joints, lungs, and the lining around the heart commonly occurs in patients who have lupus.

    • Most notably, you might see inflammation and swelling around the feet, legs, hands, and eyes.[3]
    • If you have inflamed joints, you should notice joints that are affected by arthritis and that also feel warm and tender while looking swollen and red. At least two joints must be consistently affected in this manner for six weeks.
    • Inflammation of the heart and lungs can be detected at home based on chest pain. If you feel a sharp chest pain when you cough or take a deep breath, you can count this among a possible symptom. The same applies if you are feeling a shortness of breath during these periods, as well.
    • Other signs that your heart or lungs could be inflamed include abnormal heart rhythms and the coughing up of blood.[4]
    • Inflammation can also take place in the digestive tract and can be spotted through symptoms like abdominal pain, nausea, and vomiting.
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    Pay attention to your urine. While urine abnormalities can be hard to detect at home, there are a few symptoms you might be able to look at. If the kidney is unable to filter your urine due to lupus, your feet might swell. Worse yet, if your kidneys have begun failing, you might feel nausea or weakness.
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    Note any problems with your brain and nervous system. Lupus can affect the nervous symptom, as well. While some symptoms, like anxiety, headaches, and vision problems, are common and difficult to assign to lupus, seizures and psychosis are considered to be concrete symptoms taken very seriously.

    • Psychosis is, in essence, a break from reality. You may slip into delusions or hallucinations and find it difficult to separate them from the real world around you.
    • Note that headaches are also very common with lupus, but they can be very difficult to attribute to the disease since headaches themselves are so common and have so many possible causes.
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    Ask yourself if you are more fatigued than usual. Extreme fatigue is another common symptom of lupus. It can be caused by a number of different factors, but oftentimes, these factors can be linked to lupus.

    • For instance, anemia is common in many patients with lupus. In particular, hemolytic anemia, in which the blood cells are actively being destroyed, is a serious symptom and is more common to lupus. Less serious and more common forms of anemia, like iron deficiency anemia, are less likely to be linked to the disease.

 

Part 2 of 2: Medical Exams and Professional Diagnosis

  1. Diagnose Lupus Step 8
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    Prepare for your appointment with the doctor. You can go to any general physician for a lupus diagnosis, but that doctor may refer you to other physicians who specialize in different lab tests and diagnosis tools. Typically, though, the start of a professional medical diagnosis will be at a standard physician’s office.[5]

    • Before your appointment, write down information about when your symptoms began and how intermittent they are. Also make a note of any medications and supplements you take as well as possible triggers.[6]
    • If a parent or sibling has ever had lupus or another autoimmune disorder, you should bring that information with you, as well.
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    Prepare for an Antinuclear Antibody (ANA) test.[7] ANA is an antibody that attacks the cells’ nuclei, and these ANA are present in most people with an active form of lupus. This is often used as an initial screening test.

    • While a negative result likely means that you do not have a lupus, a positive result does not necessarily mean that you do have lupus since other diseases can also cause positives. Even if you get a positive on this test, you will likely need to go through more testing before an official diagnosis can be made.
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    Get a Complete Blood Cell count (CBC). This blood test measures the amount of red blood cells, white blood cells, platelets, and hemoglobin in your blood. Certain abnormalities can be another possible sign of lupus.[8]

    • A decrease in white blood cells and a low platelet count are found in nearly 50 percent of people with lupus.
    • This test can also detect anemia, which is a common symptom of lupus by itself.
    • Note that this test is not definitive, though, and many other conditions can also cause similar abnormalities.
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    Expect a blood test measuring your Erythrocyte Sedimentation Rate (ESR). This type of test measures the rate or speed red blood cells take to settle to the bottom of a test tube within the time frame of one hour. A fast rate can indicate lupus.

    • Note that fast rates can also be symptomatic of other inflammatory conditions, cancers, and infections, so it is not an absolute test, either.
    • When inflammation occurs, blood proteins stick together and fall faster.
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    Find out about other blood tests. Since no blood test is exclusive to lupus alone, doctors usually perform a range of blood tests to help narrow down the diagnosis. While those already listed are among the most common, other possible tests your doctor might use include:

    • An Antiphospholipid Antibodies (APL) test. APLs are a type of antibody that attack phospholipids, and they tend to be present in 60 percent of patients with lupus.
    • An Anti-Sm test. Anti-Sm is an antibody that attacks the Sm protein in the cell nucleus, and it is present in about 30 percent of lupus patients. Moreover, it rarely shows up in people without lupus, so a positive result almost always guarantees a lupus diagnosis.
    • An anti-dsDNA test. Anti-dsDNA is a protein that attacks double-stranded DNA. Roughly 75 to 90 percent of lupus patients have this protein in their blood, and it is also very rare in people without lupus, so a positive result almost always results in a lupus diagnosis.
    • Anti-Ro (SSA) and Anti-La (SSB) tests. These antibodies attack the RNA proteins in your blood, and nearly 24 to 60 percent of lupus patients have this antibody. It is more common in patients with Sjögren’s syndrome, however.
    • A C-Reactive Protein (CRP) test. This protein can indicate the presence of inflammation, but there are many other conditions that can cause this protein to show up.
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    Get a urine test. Urine tests monitor the kidneys, and damaged kidneys can be a sign indicative of lupus. You might be required to provide a urine sample to measure glomerular filtration rate and proteinuria, to measure a protein and creatinine ratio, and for a urinalysis.

    • A test measuring glomerular filtration rate and proteinuria gauges how well your kidneys filter blood.
    • A test measuring your protein and creatinine ratio checks for protein loss in the urine.
    • A urinalysis checks for the presence of protein, red blood cells, white blood cells, and cellular casts in the urine.
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    Ask about imaging tests. Your doctor might order an imaging test if he or she thinks that you might have a form of lupus that affects your lungs or heart.

    • A chest x-ray can reveal shadows in your lungs, which could indicate areas of fluid or inflammation.
    • An echocardiogram uses sound waves to measure the beating of your heart and to detect possible problems within the heart.
  8. Diagnose Lupus Step 15

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    Inquire about a biopsy. If your doctor suspects that lupus has damaged your kidneys, he or she may do a biopsy to obtain a sample of kidney tissue to assess the damage and determine treatment.

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