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Understanding Lupus: How do we diagnose it?

Updated: Apr 25


Let's start today with a couple real-life cases to illustrate how lupus can manifest differently in individuals.


  • One patient with low platelets, joint pain, and a positive ANA (antinuclear antibody) test and a positive DSDNA (double-stranded DNA) was ultimately diagnosed with lupus.


  • Another patient presented with discoid lupus skin rash, and chest pain and inflammation of the heart and lungs, which led to a lupus diagnosis.


  • In more complex scenarios, lupus nephritis was diagnosed in a patient exhibiting ankle swelling and shortness of breath, showcasing a rather diverse lupus presentation.


Diagnosing Lupus:

The diagnosis of lupus relies on a combination of symptoms and laboratory findings. The SLEC criteria, developed by rheumatologists specializing in lupus, guide this process. Symptoms such as hair loss, joint pain, and rash are considered alongside positive antibodies indicative of autoimmune activity.


Understanding Symptoms:

Symptoms like photosensitivity, rash, joint pain, fevers, and changes in urine are common in lupus. However, a single symptom or positive antibody alone isn't sufficient for diagnosis. It's the amalgamation of symptoms and antibodies that aids in diagnosing lupus accurately.


Key Diagnostic Tests:

Blood tests for antibodies like ANA stands for antinuclear antibodies, DSDNA stands for double-stranded DNA antibodies, and SMIF stands for Smith antibodies, alongside checking for anemia and kidney involvement, are crucial for diagnosis.

Complement levels (C3 and C4) help gauge disease activity and guide treatment decisions.


Treatment and Hope:

Despite the complexities of lupus, there are effective treatments available. Achieving remission is a primary goal, and advancements in research offer hope for even better outcomes, including discussions about potential cures. It's essential to collaborate closely with rheumatologists, adhere to treatment plans, and stay optimistic about the future.


Diagnosing lupus requires careful consideration of symptoms and laboratory findings. While lupus presents differently in each individual, advancements in treatment offer hope for better outcomes and, perhaps one day, a cure. Remember, a positive ANA or isolated symptoms do not confirm lupus alone—it's the combination of factors that leads to an accurate diagnosis and effective management of the condition.





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