Rheumatologists diagnose lupus by combining your medical history, symptoms (like butterfly rash, joint pain, fatigue), and a physical exam with specific blood and urine tests, as there's no single definitive test; key bloodwork looks for ANA, anti-dsDNA, and kidney/liver function, while urine tests check for kidney damage, guiding treatment for this complex autoimmune condition.
No one test can diagnose lupus. A healthcare professional makes the diagnosis based on the results of blood and urine tests, symptoms, medical history and a physical exam.
To check for these antibodies, doctors usually order what is called an ANA panel, which checks for the following antibodies: anti-double-stranded DNA, anti-Smith, anti-U1RNP, anti-Ro/SSA, and anti-La/SSB.
The 11 criteria included were malar rash, discoid rash, photosensitivity, alopecia, Raynaud phenomenon, oral/nasal ulcers, arthritis (non-erosive arthritis involving 2 or more peripheral joints), serositis (pleurisy or pericarditis), renal disease (proteinuria greater than 500 mg daily or cellular RBC, granular, ...
The diagnosis of lupus is usually suspected based on clinical symptoms and signs, and then confirmed by laboratory tests ordered by your GP. Blood tests will usually include an Anti-Nuclear Antibody (ANA) test, which measures the presence of antibodies that may attack the body's own healthy tissue.
Diagnosis of lupus
If your GP thinks you could have lupus, they'll refer you to see a rheumatologist – a doctor who specialises in identifying and treating inflammatory conditions. There isn't a single test to diagnose lupus. But blood tests can check for antibodies that are often found in people with lupus.
Early lupus warning signs often mimic other illnesses, but key indicators include extreme fatigue, fever, joint pain/swelling, skin rashes (especially a butterfly-shaped rash on the face), hair loss, and sensitivity to sunlight, alongside potential issues like headaches, mouth sores, and fingers/toes turning white or blue in the cold (Raynaud's). These symptoms can appear suddenly or slowly and come and go in flares.
Other skin conditions that sometimes mimic the skin problems of lupus include melasma, psoriasis, eczema (atopic dermatitis), and facial seborrheic dermatitis. A dermatologist can diagnose these skin conditions. The symptoms of clinical depression can mimic lupus symptoms, and vice versa.
Lupus can take a long time to diagnose for a number of reasons: Some patients experience symptoms that come and go. Others might have a slow progression, where they first experience one symptom and others develop over time.
The most common symptoms include joint and muscle pain, overwhelming fatigue, skin rashes, fevers, and hair loss. Some manifestations of lupus are not immediately apparent, and early diagnosis plays an important role in preventing damage to vital organs. If you think you might have lupus, you should see your doctor.
Rheumatoid arthritis primarily targets the joints, although it can also affect the skin, eyes, lungs and heart. Lupus, however, is more systemic and can attack any part of the body, including the skin, joints, kidneys, brain and other organs.
Fatigue or extreme tiredness
The most common symptom of lupus is fatigue, which means feeling extremely tired. Fatigue can affect a person's physical and mental health and quality of life. It can also make it hard for people with lupus to socially connect with others.
The first symptoms of lupus usually occur somewhere between the teen years and the 30s and may be mild, severe, sporadic, or continual. Common general symptoms include fatigue, fever, and hair loss. Lupus can also affect individual organs and body parts, such as the skin, kidneys, and joints.
Abnormal blood work for lupus diagnosis includes:
Positive antinuclear antibody (ANA) result: antibodies that can cause the body to begin attacking itself that are present in nearly all lupus patients. Certain abnormal antibodies: anti-dsDNA, anti-Sm or antiphospholipid antibodies.
Lupus can also cause inflammation in the joints, which doctors call “inflammatory arthritis.” It can make your joints hurt and feel stiff, tender, warm, and swollen. Lupus arthritis most often affects joints that are farther from the middle of your body, like your fingers, wrists, elbows, knees, ankles, and toes.
Systemic lupus erythematosus (SLE or "lupus"), as described in medical papers, on the internet, and in public media, generally refers to the disease as seen at its peak onset ages: That is, lupus most often appears when a person is between 15 and 35 years of age – typically with symptoms of arthritis, rash, hair loss, ...
Lupus causes swelling and irritation, called inflammation, that may affect joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be hard to diagnose because its symptoms often are like those of other illnesses. A common sign of lupus is a facial rash that looks like butterfly wings across both cheeks.
Lupus can attack many different parts of the body. Some call it the cruel mystery. Lupus is an autoimmune disease that can strike any part of the body, but the wide range of symptoms can be easily mistaken for something else.
Pre-lupus, also known as pre-systemic lupus erythematosus (pre-SLE), refers to a stage where individuals exhibit some signs and symptoms similar to lupus but do not meet the full criteria for a lupus diagnosis. This is considered a stage of early autoimmunity.
Lupus and Sjogren's syndrome are both autoimmune diseases. Up to 5.5 million people in the U.S. have been diagnosed with lupus or Sjogren's syndrome. However, Sjogren's syndrome occurs up to three times more than lupus, but one-third of lupus patients also have Sjogren's syndrome.
But your doctor can find out if you have lupus in other ways, including:
Some lupus complications can include:
Lupus Signs, Symptoms, and Co-occuring Conditions
Most experts believe that several factors work together to cause lupus, including a person's genes, their hormones, and contact with environmental triggers. Environmental triggers are things in a person's surroundings (like where they live or work), habits they have, or even certain events they experience.