What a Lupus Diagnosis Looks Like

Though blood tests, such as the antinuclear antibody (ANA) test, anti-double strand DNA (dsDNA) test, anti-smith antibodies (Sm) tests, anti-phospholipid antibody test, and C# or C$ or CH50 complement level tests, are considered the “gold standard” for diagnosing systemic lupus erythematosus (SLE), certain criteria — signs and symptoms, really — assist healthcare professionals when making a lupus diagnosis.

Apart, these symptoms could be indicative of any number of diseases, which is why making a lupus diagnosis is often a difficult task for healthcare professionals. Symptoms can also develop gradually, come and go, and vary from person to person.

Because lupus is so difficult to diagnose, the Lupus Foundation of America (LFA) implores people to know the symptoms of lupus, as well as understand whether or not they are individually at risk for developing the disease.

In fact, the American College of Rheumatology uses a specific list to help rheumatologists and other doctors make a diagnosis.

Below you will find that list, accompanied by questions created by the LFA to help individuals determine whether they should contact a healthcare professional to discuss the potential for having lupus. The LFA suggests discussing the possibility with a doctor if you answer “yes” to more than three of the questions, from your present and past health history.

• Fever, fatigue, and weight loss
• Have you experienced unexplained weight loss or abdominal pain that grows worse when you breathe?
• Unexplained fever higher than 100 F for more than a few days?
• Felt extremely tired, weak, or achy for days or weeks, even after plenty of sleep?
• Arthritis involving multiple joints
• Stiff, tender, and swollen joints that are worse in the morning?
• Butterfly-shaped rash (or malar rash)
• Redness or rash across your nose, cheeks or face shaped like a butterfly?
• Skin rash appearing in sun-exposed areas
• Have you broken out after being in the sun, but it’s not sunburned?
• Sores in the mouth or nose
• Have they lasted more than a week?
• Or have you had irritation or dryness in your eyes or mouth for more than a few weeks?
• Loss of hair, sometimes in spots or around the hairline
• Did this occur for seemingly no reason?
• Seizures, strokes, and mental disorders
• Have you had a seizure or convulsion or become confused for no known reason?
• Blood clots in different locations
• Miscarriages in some patients
• Blood or protein in the urine or tests that suggest poor kidney function? Foamy urine may hint to proteinuria.
• Have your legs and ankles swollen up on both sides at the same time?
• Low blood counts (anemia, low white blood cells or low platelets)
• Chest pain
• Did this occur while taking deep breaths?
• Heartburn
• Poor circulation to the fingers and toes
• Do your fingers or toes or both become pale or red or blue and numb or painful in the cold?

Again, if you answered yes to three or more of the questions accompanying the criteria list, the LFA suggests you talk to a doctor about the possibility of lupus.