Lupus Diagnosis: When to See a Doctor and What to Expect

Early diagnosis and treatment of lupus can help patients manage their symptoms and avoid complications.

Lupus is an autoimmune disease that causes inflammation in the body, leading to a variety of symptoms and complications, ranging from rash to kidney failure. Fortunately, early diagnosis and treatment of lupus can help patients manage their symptoms and avoid complications.

But diagnosing lupus can be very challenging, says Stacy Ardoin, MD, a rheumatologist at the Ohio State University Wexner Medical Center in Columbus. Symptoms can range from a mild rash and arthritis to kidney failure and seizures — “with a whole spectrum in between,” she says. Symptoms can also mimic other diseases, including infections and cancer.

Here’s what you need to know about the warning signs, when to see your doc, and tests you can expect that help your healthcare team make a lupus diagnosis.

 

Most of the time it’s a rheumatologist, a doctor who specializes in treating joint and muscle diseases, who will make a diagnosis of lupus. But usually it’s your primary care physician who will recommend that you see a specialist after you or your primary doctor has observed some of the common lupus warning signs.

Rashes that develop on the face and upper arms after exposure to sunlight, unexplained fevers, and painful, swollen, or stiff joints are all common lupus symptoms — and are symptoms you should tell your doctor about, says Neil Kramer, MD, the co-medical director at the Institute for Rheumatic and Autoimmune Diseases at Overlook Medical Center in Summit, New Jersey.

Another signal that you may need to undergo further testing for lupus is if a routine urine test (the one you’ll likely do as part of a primary care checkup) shows abnormalities, such as excess protein or red blood cells. Those individuals may need further assessment from a rheumatologist, says Dr. Kramer. The same can be said of unexplained low blood counts.

Additionally, a diagnosis of pleuritis (inflammation of the lining surrounding the lungs) or pericarditis (inflammation of the sac around the heart) may also require further investigation. Lupus can cause both conditions, says Kramer.

 What to Expect When You See the Rheumatologist

If your doctor does refer you to a rheumatologist because he or she suspects lupus, patients can expect a thorough medical history and complete physical examination, as well as several laboratory tests, says Kramer. There’s no one test for lupus, so the rheumatologist will typically use a combination of test results and the signs and symptoms you report to make a diagnosis, adds Francis Luk, MD, an assistant professor of rheumatology and immunology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. Symptoms are subjective and include pain levels and how much fatigue a person is experiencing. Signs are measurable and can include rash or swelling of the joints, he says.

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