How is Lupus Diagnosed
In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and germs ("foreign invaders," like the flu). Normally our immune system produces proteins called antibodies that protect the body from foreign invaders. When you have lupus, your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues, so autoantibodies (auto means self and anti means against: "against self") are made that damage and destroy healthy tissue. These autoantibodies cause inflammation, pain, and damage in various parts of the body.
What Is My Doctor Looking For?
A doctor who is considering the possibility of lupus will look for signs of inflammation. The signs of inflammation are pain, heat, redness, swelling, and loss of function at a particular place in the body. Inflammation can occur on the inside of your body (your kidneys or heart, for example), on the outside (your skin), or both.
However, there are many challenges in confirming that a person has lupus and not some other disease. Lupus is known as "the great imitator," because its symptoms mimic many other illnesses. Also, lupus symptoms can be unclear, can come and go, and can change. Therefore, a lupus diagnosis is made by a careful review of:
- your current symptoms
- your laboratory test results
- your medical history
- the medical history of your close family members (grandparents, parents, brothers and sisters, aunts, uncles, cousins)
All of this information may be necessary for a doctor to make a diagnosis of lupus because, for a number of reasons, laboratory tests alone cannot give a definite "yes" or "no" answer.
- No single laboratory test can determine whether a person has lupus.
- Test results that suggest lupus can be due to other illnesses, or can even be seen in healthy people.
- A test result may be positive one time and negative another time.
- Different laboratories may produce different test results.
Frequently Asked Questions
Is there a test for systemic lupus?
There is not a single diagnostic test for systemic lupus. A variety of laboratory tests are used to detect physical changes or conditions in your body that can occur with lupus. Each test result adds more information to the picture your doctor is forming of your illness.
What kind of doctor can diagnose systemic lupus?
If multiple criteria are present simultaneously, the diagnosis may be made by any physician (Family Practitioner, Internist, or Pediatrician). If however, as is often the case, symptoms develop gradually over time, the diagnosis may not be as obvious and consultation with a rheumatologist may be needed.
Where is the BEST place to go for diagnosis and treatment of lupus?
There is no one single recognized center of excellence for the treatment and diagnosis of lupus in the United States today. The Lupus Foundation of America has no mechanism by which it can rate either hospitals or physicians. The general recommendation is to find a physician that is affiliated with a medical school -- a university hospital for example. These health care institutions may have faculty on staff who are involved in lupus research, and are generally the most up-to-date on the latest advances in diagnosis and treatment of lupus. These are generally regarded as very good places to go for the diagnosis and treatment of lupus. Certainly the health care institutions with established reputations fit this description.