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Subject: Diagnosis of Lupus - Lupus Foundation of America, Inc.

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Lupus Foundation of America, Inc.www.lupus.org1300 Piccard Drive, Suite 200Rockville, MD 20850-4303Phone (301)670-9292Fax (301)670-9486Contact Us

Words of Caution

DIAGNOSIS: Because many lupus symptoms mimic other illnesses, are sometimes vague and may come and go, lupus can be difficult to diagnose. Diagnosis is usually made by a careful review of a person's entire medical history coupled with an analysis of the results obtained in routine laboratory tests and some specialized tests related to immune status. Currently, there is no single laboratory test that can determine whether a person has lupus or not. To assist the physician in the diagnosis of lupus, the American College of Rheumatology (ACR) in 1982 issued a list of 11 symptoms or signs that help distinguish lupus from other diseases (see Table 2). This has recently been revised. A person should have four or more of these symptoms to suspect lupus. The symptoms do not all have to occur at the same time.

Table 2The Eleven Criteria Used for the Diagnosis of Lupus

Criterion

Definition

Malar Rash

Rash over the cheeks

Discoid Rash

Red raised patches

Photosensitivity

Reaction to sunlight, resulting in the development of or increase in skin rash

Oral Ulcers

Ulcers in the nose or mouth, usually painless

Arthritis

Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed)

Serositis

Pleuritis or pericarditis (inflammation of the lining of the lung or heart)

Renal Disorder

Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)

Neurologic Disorder

Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects

Hematologic Disorder

Hemolytic anemia or leukopenia (white blood count below 4,000 cells per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.

Antinuclear Antibody

Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it.

Immunologic Disorder

Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL).

Adapted from: Tan, E.M., et. al. The 1982 Revised Criteria for the Classification of SLE. Arth Rheum 25: 1271-1277. Learn more...

Definition

Flares

Types

Treatment

Cause

Nutrition and Diet

Symptoms

Pregnancy

Diagnosis

Prognosis

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The Lupus Foundation of America

© 2001 Lupus Foundation of America, Inc.

Home | About LFA | Mailing List | Chapter Locator | LFA Store | Sitemap

www.lupus.org

LFA Home : Education : Facts and Overview : What Is Lupus? : Diagnosis

search:

Choose Section

--------------------------

- Education

- Support

- LFA Research

- What's New?

- LFA In Action

- News

- Research

- Awareness

Lupus Disease

----------------------------

- Cutaneous (skin)

- Drug-Induced

- Neonatal

- Overlap

- Systemic

Education

Facts & Overview

Information and

Publications

Links & Resources

Support

LFA Research

What's New?

Lupus Foundation

of America, Inc.

www.lupus.org

1300 Piccard Drive,

Suite 200

Rockville, MD 20850-4303

Phone (301)670-9292

Fax (301)670-9486

Contact Us

Words of Caution

DIAGNOSIS:

Because many lupus symptoms mimic other illnesses, are sometimes vague and may come and go, lupus can be difficult to diagnose. Diagnosis is usually made by a careful review of a person's entire medical history coupled with an analysis of the results obtained in routine laboratory tests and some specialized tests related to immune status. Currently, there is no single laboratory test that can determine whether a person has lupus or not. To assist the physician in the diagnosis of lupus, the American College of Rheumatology (ACR) in 1982 issued a list of 11 symptoms or signs that help distinguish lupus from other diseases (see Table 2). This has recently been revised. A person should have four or more of these symptoms to suspect lupus. The symptoms do not all have to occur at the same time.

Table 2

The Eleven Criteria Used for the Diagnosis of Lupus

Criterion

Definition

Malar Rash

Rash over the cheeks

Discoid Rash

Red raised patches

Photosensitivity

Reaction to sunlight, resulting in the development of or increase in skin rash

Oral Ulcers

Ulcers in the nose or mouth, usually painless

Arthritis

Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed)

Serositis

Pleuritis or pericarditis (inflammation of the lining of the lung or heart)

Renal Disorder

Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)

Neurologic

Disorder

Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects

Hematologic

Disorder

Hemolytic anemia or leukopenia (white blood count below 4,000 cells per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.

Antinuclear

Antibody

Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it.

Immunologic

Disorder

Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL).

Adapted from: Tan, E.M., et. al. The 1982 Revised Criteria for the Classification of SLE. Arth Rheum 25: 1271-1277. Learn more...

Definition

Flares

Types

Treatment

Cause

Nutrition and Diet

Symptoms

Pregnancy

Diagnosis

Prognosis

Laboratory Tests

The Lupus Foundation of America

© 2001 Lupus Foundation of America, Inc.