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Lupus diagnosis and screening

Because of its chameleonic nature and the specific fluctuations, lupus is a very difficult to diagnose disease. Different people with lupus experience different symptoms, symptoms that interfere with those of other conditions. The signs must be very clear before you receive a lupus diagnosis because it has remissions and relapses. There are times in which it may become extremely serious and others in which it acts exactly as an underlying condition.

A series of clinical and laboratory criteria have been issued by the ACR ( American College of Rheumatology) specialists in order to diagnose lupus or to identify its type. There are eleven criteria designed to help the doctors to properly diagnose this condition. In case four of them are met, there are strong reasons for the doctors to believe that the patient has lupus. The eleven criteria are:

• * Discoid rash – scaly patches, which are raised and generate scarring.
• * Diseases of the kidneys
• * Psychosis, seizures or other problems of the nervous system.
• * Blood problems (anemia, low platelets or leucopenia)
• * Hypersensitivity to sunlight.
• * Ulcers of the mouth.
• * More than 2 peripheral articulations affected by arthritis but not destroyed.
• * Diseases of the immune system, shown by the positive results of the anti-Sm test, double – stranded anti – DNA test, false positive test for syphilis; all these show the presence of an autoimmune disorder.
• * Antinuclear antibody – indicates autoimmune diseases.
• * Malar rash – a rash that covers the nose and extends to the cheeks.

Tests performed in laboratory

Besides the physical examination and the revision of the patient's medical record, laboratory tests are also required for a correct diagnosis. The tests performed in laboratory to identify the presence of lupus are:

• * Urinalysis, a test that checks the level of proteins and red blood cells on a urine sample. The damage produced by lupus on the kidneys usually increases these levels.
• * Chest X-ray shows a possible inflammation or fluid retention inside of lungs under the appearance of shadows. This test also detects pericardial effusion – increased dimensions of the heart caused by fluid retention inside the pericardium.
• * Complete blood count detects a possible anemia, very frequent in lupus, by means of the measuring of the leukocytes, red blood cells and platelets. The quantity of hemoglobin is also measured. A low number of platelets and leukocytes may also suggest lupus.
• * Electrocardiogram (ECG) identifies irregularities of the heart rate or heart damage through the measuring of the electrical impulses inside this vital organ.
• * The syphilis test and its false – positive result may be a sign of lupus; they indicate that anti – phospholipids antibodies are there, which often occurs with lupus and increases the possibility of strokes, blood clots or recurrent miscarriages.
• * Assessment of the liver and kidney – determine whether the activity of these organs is normal or not. Lupus causes abnormalities of their functions.
• * Anti-nuclear antibody test (ANA) – a positive result shows that an autoimmune disease, such as lupus, because the antibodies are only produced when the immune system is stimulated by something. But a positive result may also be generated by a possible infection or by some particular drugs. To determine it for sure, further antibody tests will be performed by a specialist in autoimmune and musculoskeletal disorders.
• * Erythrocyte sedimentation rate measures the rate of the red blood cells when they settle to the bottom of a tube. This test takes about 60 minutes. A rate that is faster than the average may indicate lupus or other systemic disease or even an infection.