Diagnosing Lupus
Diagnosing lupus can be challenging. While the vast majority of patients with lupus have a positive ANA, the blood test does not make the diagnosis of lupus itself, as one in five healthy people have a positive ANA but fewer than one in 50 of those with a positive ANA have lupus. In addition, people with lupus can present in many different ways, and symptoms can be vague.
Our specialists at UT Southwestern have expertise in diagnosing lupus. In addition to taking a thorough medical history and performing a comprehensive physical examination, doctors might order a number of studies.
Blood testing is commonly used to:
- Assess blood counts and platelet counts
- Evaluate kidney function
- Detect antibodies that are present in most people with lupus
- Measure other markers of immune activation such as complement
- Look for markers of inflammation such as the c-reactive protein and the erythrocyte sedimentation rate (sed rate)
- Evaluate kidney function with a urinalysis and blood test
A small tissue sample (biopsy) might be taken to look for signs of damage or inflammation. This is most commonly done with the skin and the kidneys.
Treating Lupus
How patients with lupus are treated depends on disease severity and organ involvement.
- Nonsteroidal anti-inflammatory medications (NSAIDs) can be used to treat joint pain and inflammation of the lining of the lungs and heart.
- All patients, unless contraindicated, should be treated with an antimalarial drug such as hydroxychloroquine.
- Corticosteroids can be used to control inflammation.
- Disease-modifying drugs are used to treat skin and joint disease.
- Immunosuppression and biologics are used to treat kidney disease.
Other ways to manage the disease include:
- Limited sun exposure with liberal use of sunscreen, decreased time outdoors between 10 a.m. and 4 p.m., and wearing hats and long sleeves when outdoors
- Adequate sleep and rest
- Smoking cessation
- Stress reduction
- Eating a well-balanced diet
Treatment for lupus and its related complications depends upon:
- Severity and extent of the condition
- Patient age, overall health, and medical history
- Organs affected
- Expectation for the course of the disease
- Patient preferences and tolerance for medications, procedures, and therapies