Re: who dx these conditions and how?
Hi. Usually rheumatologists diagnose lupus, antiphospholipid syndrome, rheumatoid arthritis, Sjogren's, mixed connective tissue disease, and scleroderma. For Hashimoto's, Grave's, and type 1 diabetes: endocrinologists. For multiple sclerosis: neurologists. For inflammatory bowel conditions (Crohn's & ulcerative colitis): gastroenterologists. (Did I omit the ones you're most interested in?!?)
The "how" depends on the condition. I believe all (or most) have pre-determined criteria set by professional societies. In lupus, for example, there are 11 criteria established by the American College of Rheumatology. A patient generally (not always) must meet 4 or more to sustain a Dx of SLE. (You could read these on a "sticky posts" on the lupus board.)
Some criteria are subjective in nature, so doctors take a full medical history & ask questions. One example of a subjective criteria in lupus would be the one re: skin & sun sensitivity. (There's no test to prove it.)
Other criteria are quantifiable, like lab results. Doctors run the basics, like CBC metabolic panel, urinalysis, etc., then add more. In many of the AI's, a very general threshold test called antinuclear antibody (ANA) is often positive. Additional autoantibody tests that are more specific are tacked on. In lupus, those would be tests like anti-ds-DNA, anti-Sm, anti-Ro, anti-La, anti-RNP, anticardiolipin, etc. (There are a bunch.)
Sometimes one specialist refers you to additional specialists. In lupus, perhaps a dermatologist to biopsy a rash, or a nephrologist to fully evaluate kidney function, etc.
We're just patients, but if you wanted to post some of your symptoms, we could suggest (in our non-professional opinions) which specialist(s) you might consider... but a good PCP can get the ball rolling even faster, as he/she tends to know which specialists in your area are good at diagnosing the complex stuff. Hope this is what you're really after---let us know, OK? Sending best wishes, sincerely, Vee
Last edited by VeeJ; 03-08-2013 at 10:33 AM.