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  • Criteria to Diagnose Lupus

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    Old 10-04-2003, 04:13 PM   #1
    AngelicBrat
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    Exclamation Criteria to Diagnose Lupus

    Here is the classification of Lupus for you guys. I posted this under the Lupus board, but thought that there were lots of "mystery" people out there that may want to read this. I must add that you CAN have Lupus without the positive Lupus, and they call it "seronegative Lupus". Lots of people that are seronegative usually can go on to be positive, so its important to relay all of your symptoms on to your doctor!

    SYMPTOMS OF SLE
    Arthralgia (Joint pain)
    Arthritis
    Fever (>100*F)
    Skin Rashes
    Anemia
    Kidney Damage
    Pleurisy
    Facial Rash
    Photosensitivity
    Aloopecia (hair Loss)
    Raynauds' Phenomenon
    Seizures
    Mouth or Nose Ulcers

    ACR CRITERIA FOR DIAGNOSING SLE
    Malar Rash
    Discoid Rash
    Photosensitivity
    Oral Ulsers
    Arthritis
    Serositis (pleuritis or pericarditis)
    Renal Disorder (persistent Proteinuria in the urine or cellular casts)
    Neurological disorder (seizures or psychosis)
    Hematologic disorder (anemia, Leukopenia or lymphopenia on two or more occasions, thrombocytopenia
    Immunologic disorder (positive LE cell preparation, abnormal anti-DNA or ANTI-Sm values, False postive VDRL (syphilis test)
    Abnormal ANA Titre

    "The american College of Rheumatology (ACR) an organization of doctors and associated health professionals who specialize in arthritis and related diseases of the bones, joints and muscles, has developed and refined a set of diagnostic criteria...if at least 4 of the 11 criteria develop at one time or individually over any period of observation, then the patient is likely to have SLE however, a diagnosis of SLE can be made in a patient having fewer than four of these symptoms."

    That being said, Dr. Graham Hughes and his team at St Thomas' Hospital in London England have put together another list to help diagnose people that are not as easy to diagnose:

    ST THOMAS HOSPITAL CRITERIA FOR DIAGNOSING SLE

    1. Teenage "growing pains"

    Growing pains in the UK, is a label widely used for joint pains in teenagers and seems to cover a spectrum of rheumatology from arthritis varients through to lupus.

    2. Teenage migraine

    Headache, cluster headache and migraine can be encountered and a strong history of teenage migraine may be of lupus significance, either at that time or subsequently.

    3. Teenage "glandular fever"

    Prolonged teenage glandular fever is a label which crops up time and time again in lupus patients and prolonged periods off school in many SLE patients is a recurrent theme.

    4. Severe reaction to insect bites

    This is a feature of so many lupus patients. Not only are they susceptible to insect bites but often reactions are severe and prolonged - the skin is a major organ affected by lupus.

    5. Recurrent miscarriages

    Lupus itself seems not to be a cause of recurrent miscarriage but where the antiphospholipid syndrome (APS) is present, recurrent spontaneous fetal loss can be significant.

    6. Premenstrual exacerbations

    Although difficult to quantify, it is believed that significant pre-menstrual disease flare is sufficiently prominent in lupus to be included in this list. All rheumatic diseases are clinically influenced by the menstrual cycle.

    7. Septrin (and sulphonamide allergy)

    Adverse reactions to these drugs is quite common in lupus and the clinical onset of the disease may have coincided with the use of eg Septrin.

    8. Agoraphobia

    Agoraphobia/claustrophobia are often present at a time when lupus disease is active. A history of these conditions can be protracted, lasting for months or even years. In many cases the history is not volunteered or the episodes are in the interim considered unrelated to lupus.

    9. Finger Flexor Tendonitis

    Arthralgia and tenosynovitis are common features in lupus and although not specific, the finding of mild to moderate ten-finger flexor synovitis is a useful pointer in the presence of other lupus features. It is subtly yet significantly different in pattern from other arthritic diseases.

    10. Family history of autoimmune disease

    As the genetics and statistics of the various autoimmune diseases become better defined, the strength of a particular family history will become more precise. The family history is important, as lupus is genetically determined.

    11. Dry Shirmer's Test

    A "bone dry" Shirmer's Test (levels of eye moisture) points towards one of the autoimmune diseases and in the patient with vague or nonspecific symptoms is worth its weight in gold.

    12. Borderline C4

    Genetic complement deficiencies have been known to be associated with lupus for over three decades and in the diagnostically difficult patient, especially where a family history is present, borderline C4 levels can be significant indicators.

    13. Normal CRP with raised ESR

    An important diagnostic aid. A very low CRP in an otherwise inflammatory situation is strongly supportive of lupus or primary Sjögren's Syndrome.

    14. Lymphopenia

    In the patient with non-specific complaints and unremarkable blood tests, a borderline or low lymph count can be overlooked. It can be common in lupus and is certainly worth inclusion among minor criteria.


    That all being said, I recommend that you sit down and write every day what is going on with you symptom wise, because the journey to being diagnosed can be so long and so frustrating. I hope this helps you!!

    ~Angelic

     
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    Old 11-21-2003, 05:37 AM   #2
    GEDEN13
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    Re: Criteria to Diagnose Lupus

    hi...you might remember me..i wrote about plaquenil awhile..anyway i was doing a search on here for synovitis,and your name came up.i know you have lupus.(im so sorry) i am dealing with lymes.putting that aside,you mentioned synovitis on this post.do you have it?i do.what i need is some info from a person who is dealing with synovitis.i had an open synovectomy in march.doc removed a bunch stuff.(pretty nasty,i wont describe) its been 9 months and pain and swelling continue.range of motion is limited.are you dealing with same?if you could offer any info on my situation,i would be in your dept.thanks for your time.......gary

    Last edited by moderator2; 04-03-2005 at 09:20 AM. Reason: please delete long quotes

     
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