Diagnostic Tests for Lupus


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Diagnostic Test list for Lupus: The list of diagnostic tests mentioned in various sources as used in the diagnosis of Lupus includes:

Tests and diagnosis discussion for Lupus: Go see a doctor. He or she will talk to you and take a history of your health problems. Many people have lupus for a long time before they find out they have it. It's important that you tell the doctor or nurse about your symptoms. This information, along with a physical examination and the results of laboratory tests, helps the doctor decide whether you have lupus or something else.

A rheumatologist (ROOM-uh-TALL-uh-jist) is a doctor who specializes in treating diseases that affect the joints and muscles, like lupus. You may want to ask your regular doctor for a referral to a rheumatologist.

In some cases, a dermatologist, a doctor who specializes in treating diseases that affect the skin, may be involved in diagnosis and treatment. No single test can show that you have lupus. Your doctor may have to run several tests and study your medical history. It may take time for the doctor to diagnose lupus. 1

Diagnosing lupus can be difficult. It may take months or even years for doctors to piece together the symptoms to diagnose this complex disease accurately. Making a correct diagnosis of lupus requires knowledge and awareness on the part of the doctor and good communication on the part of the patient. Giving the doctor a complete, accurate medical history (for example, what health problems you have had and for how long) is critical to the process of diagnosis. This information, along with a physical examination and the results of laboratory tests, helps the doctor consider other diseases that may mimic lupus, or determine if the patient truly has the disease. Reaching a diagnosis may take time and occur gradually as new symptoms appear.

No single test can determine whether a person has lupus, but several laboratory tests may help the doctor to make a diagnosis. The most useful tests identify certain autoantibodies often present in the blood of people with lupus. For example, the antinuclear antibody (ANA) test is commonly used to look for autoantibodies that react against components of the nucleus, or "command center," of the patientís own cells. Most people with lupus test positive for ANA; however, there are a number of other causes of a positive ANA besides lupus, including infections, other rheumatic or immune diseases, and occasionally as a finding in normal healthy adults. The ANA test simply provides another clue for the doctor to consider in making a diagnosis. In addition, there are blood tests for individual types of autoantibodies that are more specific to people with lupus, although not all people with lupus test positive for these and not all people with these antibodies have lupus. These antibodies include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), and anti-La (SSB). The doctor may use these antibody tests to help make a diagnosis of lupus.

Some tests are used less frequently but may be helpful if the cause of a personís symptoms remains unclear. The doctor may order a biopsy of the skin or kidneys if those body systems are affected. Some doctors may order a syphilis test or a test for anticardiolipin antibody. A positive test does not mean that a patient has syphilis; however, the presence of this antibody may increase the risk of blood clotting and can increase the risk of miscarriages in pregnant women with lupus. Again, all these tests merely serve as tools to give the doctor clues and information in making a diagnosis. The doctor will look at the entire picture--medical history, symptoms, and test results--to determine if a person has lupus.

Other laboratory tests are used to monitor the progress of the disease once it has been diagnosed. A complete blood count, urinalysis, blood chemistries, and erythrocyte sedimentation rate (ESR) test can provide valuable information. Another common test measures the blood level of a group of substances called complement. People with lupus often have increased ESRs and low complement levels, especially during flares of the disease.

Diagnostic Tools for Lupus

  • Medical history

  • Complete physical examination

  • Laboratory tests:
    • Complete blood count
    • Erythrocyte sedimentation rate (ESR)
    • Urinalysis
    • Blood chemistries
    • Complement levels
    • Antinuclear antibody test (ANA)
    • Other autoantibody tests (anti-DNA, anti-Sm, anti-RNP, anti-Ro [SSA], anti- La [SSB])
    • Syphilis test or anticardiolipin antibody
  • Skin or kidney biopsy
2

Early diagnosis and treatment are needed to improve health and reduce tissue damage. Diagnosing lupus can be difficult, however, because it may take months or even years for doctors to piece together the symptoms to make an accurate diagnosis. Giving the doctor a complete, accurate medical history is critical to the process of diagnosis. This information, along with a physical examination and the results of laboratory tests, helps the doctor rule out other diseases that may mimic lupus. Reaching a diagnosis may take time and occur gradually as new symptoms appear. 3

Diagnosis of Lupus: medical news summaries: The following medical news items are relevant to diagnosis of Lupus:



Footnotes:
1. excerpt from The Many Shades of Lupus: NIAMS
2. excerpt from Handout on Health Systemic Lupus Erythematosus: NIAMS
3. excerpt from Lupus Fact Sheet: NWHIC

Last revision: June 2, 2003

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