Diagnosing Lupus

Your doctor will try to rule out several other conditions by doing a number of tests.

Diagnosing lupus is challenging because there is no simple test to confirm the condition. It can often take several months—and in some cases, much longer—for your doctor to confirm the diagnosis. This is because lupus symptoms may imitate many other diseases, so your doctor must carefully sort through those possibilities as he or she tries to diagnose your symptoms. A rheumatologist who specializes in the management and treatment of lupus should confirm the diagnosis.

The primary symptoms of lupus—such as joint pain, weight loss, fatigue, and headache—match many other health conditions. However, if you have rashes, your skin is overly sensitive to the sun, or you have ulcers in your mouth, your doctor may suspect lupus.

Lupus DiagnosisDetecting lupus can be hard because of its many symptoms that come on slowly. (Source: 123RF)

Tests for Diagnosing Lupus

To start the diagnosis process, your doctor will begin with a complete medical exam that will include:

  • A complete review of your medical history with an emphasis on your current medications.
  • Questions about your family's medical history.
  • An examination of your skin for rashes, as well as checking your heart, lungs, joints, abdomen, nerves, and muscles.
  • Blood tests including an antinuclear antibody (ANA) test that checks for antibodies consistent with a heightened autoimmune response (while this can occur with lupus, it can also be caused by other things), and other blood tests that check for lupus markers including low red blood cells (anemia), low white blood cells, and low platelet counts, since any of these can occur with lupus.
  • Urine tests to look for an increased protein level or red blood cells in the urine (a possible sign that lupus is affecting your kidneys).
  • Chest radiograph (x-ray) to look for heart or lung abnormalities.

Your doctor may need additional tests on specific organs or tissues. He or she is looking for the changes that point to lupus—or rule it out.

Blood Tests for Lupus Diagnosis

One of the things your doctor is looking for in your blood tests is the presence of autoantibodies—the immune system proteins that are associated with immune system dysfunction. This is tricky because there are many types of antibodies. Furthermore, antibodies are always present in our system because they are always fighting bacteria, viruses, and other germs. If your doctor sees lupus-related antibodies consistently present in your blood, he or she may diagnose you with lupus.

Keep in mind that no one test alone is indicative of lupus. It is the combination of results, along with observing your health and symptoms over time, that can help your doctor finalize a lupus diagnosis.

Visiting a Rheumatologist

You will probably start the lupus exploration and diagnosis process with your primary care provider. However, you will benefit from also working with a rheumatologist, a doctor who specializes in treating lupus and other disorders of the immune system. Read more on why lupus takes so long to diagnose.

-Additional reporting by Lisa Ellis, October 2018

Updated on: 07/09/19
Continue Reading:
A Closer Look at Lupus Treatments