Lupus Site - a guide for lupus patients and their families

Lupus is a difficult disease to diagnose, & can be overlooked, often for years, unless the GP or consultant is alert to it's possibilities.

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How do doctors know if you�ve got Lupus?

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• Your medical history - what you tell the doctor
• What they find when we examine you
• What the blood tests show

To help distinguish Lupus from other diseases, physicians of the American Rheumatism Association have established a list of 11 abnormalities which, when combined, point to lupus.

To make a diagnosis of Lupus the patient must have had at least FOUR of these 11 manifestations at any time since the onset of the disease.

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�	Mucosal 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, pain in the joints �
7	Renal disorders	usually detected by routine blood and urine analysis
8	Neurological disorder	seizures or psychosis
9	Haematological disorder	haemolytic anaemia, leukopenia, thrombocytopenia �
10	Immunologic disorder	tests on LE cells, anti-DNA and anti-SM antibodies �
11	Anti-Nuclear Antibody (ANA blood 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 is not necessarily conclusive �

The above criteria were laid down by the ACR in 1982. �Dr Graham Hughes �(St. Thomas' Hospital, London) has since come up with an 'alternative list of criteria'. �

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What blood tests are done to help diagnose Lupus?

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Full Blood Count (FBC) - Detects anaemia, low platelets, low white blood cells

Creatinine and electrolytes - Measures the salts in the blood and gives an idea of kidney function

Liver function tests - Includes measurement of liver enzymes (indicator of liver cell damage). Measures albumin (marker of kidney problem with leakage of the proteins)

ESR (Erythrocyte Sedimentation Rate) - A marker of non-specific inflammation, tends to be raised in lupus

CRP (C-reactive protein) - Another inflammatory marker, but this does NOT usually go up in Lupus

Urine - Measure protein and blood cells in urine (should be none). Identify �casts� (blobs of protein escaped from the bloodstream because the kidneys are leaky)

Blood clotting tests - Tell how �sticky� the blood is. Includes �lupus anti-coagulant�

Immunological tests

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For more information on blood tests see the blood tests page.