Lupus can be very hard to diagnose due to the variety and vagueness of symptoms that patients experience. Oftentimes, it takes many years before a patient is correctly diagnosed with lupus. I had symptoms for many years, but they were very mild and infrequent so I never told my doctor about them. It wasn’t until I had a flare that I was finally diagnosed.
The first step in being diagnosed is going to your primary doctor. They will take your medical history, do a thorough examination and order labwork. They will test your urine for signs of infection and protein. and test your blood to check your kidney and liver function, blood count, and inflammatory markers.
One test they use to screen for lupus is called the ANA. ANA stands for anti-nuclear antibodies. The test is sensitive for lupus, but not specific. This means it is unlikely that someone who has a negative ANA has lupus, but also that someone who has a positive ANA may not necessarily have lupus. A positive ANA cannot diagnose lupus on its own but it can indicate that lupus or another autoimmune disease is present.
The next step is to the see the rheumatologist. Many rheumatologists require a referral from the primary doctor, and some also require a positive ANA result. The rheumatologist will review your medical history and previous labs, and then conduct a focused examination to look for signs such as sores in the mouth or nose, rashes, and joint pain or swelling. They will then order blood work to test for specific antibodies related to lupus, as well as antibodies for other autoimmune conditions. If they suspect kidney disease, they may also order a kidney biopsy.
In my next post I will discuss the updated diagnostic criteria for lupus.