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Diagnosing Lupus (SLE)

The American College of Rheumatology have developed criteria for diagnosing lupus - just as they have for diagnosing fibromyalgia. They are as follows:

 

Criteria

Definition

1

Malar rash

Fixed erythema over cheeks but sparing nose-cheek folds

2

Discoid rash

Raised red patches with scarring in older lesions

3

Photosensitivity

Skin rash as a result of unusual reaction to sunlight

4

Mouth ulcers

Oral or nasal ulcers - must be observed by a physician

5

Arthritis

Tenderness and swelling in at least 2 joints observed by a physician

6

Serositis

Either: 1. Pleurisy on examination by a physician or Xray changes

or 2. Pericarditis noted by a physician or ECG changes

7

Kidney disease

1. Persistent protein in the urine of 0.5 grams or more

or 2. Cellular casts (maybe red cells, white cells or hemoglobin)

8

Blood disease

One of the 4 following:

  1. Hemolytic anemia with reticulocytosis
  2. Leukopenia with a white cell count of less than 4,000/mm2
  3. Lymphopenia with a lymphocyte count of less than 1,500/mm2
  4. Thrombocytopenia with a platelet count of less that 100,000/mm2

9

Brain disease

Either: 1. Psychosis or 2. Seizures. Both must be without other causes

10

Positive ANA

An abnormal titer of an anti-nuclear antibody (ANA) test in the absence of other diseases or drugs known to cause a positive ANA.

11

Other antibodies

Any one of these 4 tests:

  1. A positive LE cell preparation
  2. A positive test for anti-DNA antibodies
  3. A positive test for the Sm nuclear antigen
  4. A false positive for syphilis

 To have a definite diagnosis of lupus you must have 4 or more of the above features: 

  Also see:    What is an ANA ?

 

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