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The Diagnosis

In arriving at a firm diagnosis the physician will normally expect at least four of a list of 11 internationally accepted conditions to be present (either currently or at any time since the onset of the illness) The American Rheumatism Association established the of 11 abnormalities which are;

  1.  MALAR RASH – Fixed red rash over the cheeks
  2. DISCOID RASH – Red patches of skin associated with scaling and plugging of the hair follicles
  3. PHOTOSENSITIVITY – Rash after exposure to sunlight
  4. ORAL ULCERS – Small sores that occur in mucosal lining of mouth and nose
  5. SEROSITIS – Inflammation of the delicate tissues covering internal organs, and abdominal pain 
  6. ARTHRITIS – Very common in lupus, usually pain in the joints and tendons
  7. RENAL DISORDERS – Usually detected by routine blood and urine analysis
  8. NEUROLOGICAL DISORDERS – Seizures or psychosis, balance problems
  9. HAEMOTOLOGICAL DISORDER – Haemolytic Anaemia, Leukopenia, Thrombocytopenia
  10. IMMUNOLOGIC DISORDER – Tests anti-DNA, anti-SM antibodies, antiphospholipid antibodies
  11. ANTI-NUCLEAR ANTIBODY (ANA TEST) – When found in the blood and the patient is not taking drugs, it is known to cause a positive test for lupus in most cases, but it is not necessarily conclusive

Diagnosis of lupus is never straightforward, the real cause is still far from clear and the symptoms can vary widely from day to day in any one patient. Diagnosis is usually achieved through a rheumatologist but other specialists may also be involved, e.g. dermatologists, kidney specialists, cardiologists, obstetricians.