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Lupus; Diagnosis.

Diagnosing systemic lupus erythematosus (SLE) is not easy. Sometimes the disease announces itself decisively with a flare resembling an infection, but more often the early stages of the disease produce only vague symptoms such as aches, rashes or fatigue, which gradually worsen over time. Lupus symptoms can be easily confused with those of other diseases.

The most common symptoms, affecting more than half of those with lupus include:

arthralgia (joint pain)

arthritis (joint warmth, swelling and redness)

unexplained fever (over 100 degrees Fahrenheit)

extended or severe fatigue

skin rashes

anemia (abnormally low red blood cell count)

kidney damage

alopecia (hair loss)

Less common symptoms include:

pleurisy (chest pain when breathing deeply, caused by inflammation of the lungs' lining)

photosensitivity rashes that appear after exposure to sunlight

baldness on areas of the scalp

Raynaud's syndrome (fingers turning white or blue in the cold)

seizures, psychosis and other neuropsychiatric problems

mouth or nose ulcers

pericarditis (chest pain caused by inflammation of the heart lining)

phlebitis (blood clots)

Consult a health care professional as soon as possible if you have any of the symptoms listed above, whether singly or in combination. Multiple symptoms indicate a stronger likelihood that lupus is the culprit, and a rheumatologist should evaluate you.

An evaluation for lupus consists of a thorough medical history, a physical examination and laboratory tests.

An initial diagnostic screening usually includes a complete blood count, liver and kidney tests, blood tests for autoantibodies (increased antibodies that target healthy issues and are an indicator of autoimmune disease), skin biopsy, urinalysis (to detect possible kidney disease), blood chemistry work-up and erythrocyte sedimentation rate (a measure of inflammation).

The antinuclear antibody (ANA) test detects autoantibodies that react against components of the nucleus, or "command center," of your own cells. A positive test indicates a stimulated immune system, which is common in people with lupus. However, ANA is also positive for other conditions, such as systemic sclerosis, mixed connective tissue disease and rheumatoid arthritis. In addition, people without such disorders could have a positive ANA test. A positive ANA is common in people over 50.

Other autoantibody tests include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA) and anti-La (SSB). Anticardiolipin or other antiphospholipid tests may indicate risk for a blood clotting disorder. In some cases, specialized diagnostic tests for the eyes, heart lungs or brain, or a biopsy of the skin or kidney may be performed.

Clearly, diagnosing lupus is a complex matter. If there is a reasonable likelihood that you have lupus, you will need a referral to a rheumatologist.

References

The Lupus Foundation of America. 2008. http://www.lupus.org. Accessed June 2008.

"Lupus Causes." The Mayo Clinic. October 2007. http://www.mayoclinic.com. Accessed February 2008.

"Medicines." The Lupus Foundation of America. 2008. http://www.lupus.org. Accessed February 2008.

"COX-2 Selective and Non-Selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)." U.S. Food and Drug Administration Center for Drug Evaluation and Research. http://www.fda.gov. Updated April 15, 2005. Accessed June 3, 2005.

"FDA Issues Public Health Advisory on Vioxx as its Manufacturer Voluntarily Withdraws Its Product." U.S. Food and Drug Administration. http://www.fda.gov. Accessed October 1, 2004.

Lupus Foundation of America. http://www.lupus.org. Accessed June 8, 2004.

http://www.lupus.org. Accessed June 8, 2004.

http://clinicalstudies.info.nih.gov. Accessed June 8, 2004.

"Lupus: A Patient Care Guide for Nurses and Other Health Care Professionals." erythematosus." National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2001. http://www.niams.nih.gov. Accessed June 8, 2004.

"Handout on Health: Systemic Lupus Erythematosus." National Institute of Arthritis and Musculoskeletal and Skin Diseases. Revised August 2003 http://www.niams.nih.gov. Accessed June 8, 2004.

"Patient Information Sheet #1: Living With Lupus." National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2001. http://www.niams.nih.gov. Accessed June 8, 2004.

"Treatment." Lupus Foundation of America. http://www.lupus.org. Accessed June 8, 2004

"Lupus is a Significant Health Issue for Women and People of Color." May 2001. The National Women's Health Information Center. http://www.4woman.gov. Accessed June 8, 2004.

"Drugs Approved by the FDA: Drug Name: Mobicr (meloxicam) Tablets" CenterWatch Clinical Trials Listing Service. Updated Nov. 14 2000. http://www.centerwatch.com. Acessed June 8, 2004.

"Targets for New SLE Treatments" Division of Rheumatology of The Hospital for Special Surgery. January 2002. http://rheumatology.hss.edu. Accessed June 8, 2004.

Keywords: lupus, systemic lupus erythematosus, sle, symptoms, autoantibodies, ana
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Publication:NWHRC Health Center - Lupus
Article Type:Disease/Disorder overview
Geographic Code:1USA
Date:Jun 19, 2008
Words:740
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