|
|
|
What
is Lupus?
|
|
Lupus is a chronic inflammatory disease that can affect various parts
of the body, especially the skin, joints, blood, and kidneys. The body's
immune system normally makes proteins called antibodies to protect the
body against viruses, bacteria, and other foreign materials. These foreign
materials are called antigens. In an autoimmune disorder such as lupus,
the immune system loses its ability to tell the difference between foreign
substances (antigens) and its own cells and tissues. The immune system
then makes antibodies directed against "self". These antibodies,
called "auto-antibodies" react with the "self"
antigens to form immune complexes. The immune complexes build up in the
tissues and can cause inflammation, injury to tissues, and pain.
For most people, lupus is a mild disease affecting only a few organs. For
others, it may cause serious and even life-threatening problems. More than
16,000 Americans develop lupus each year. It is estimated that 500,000 to
1.5 million Americans have been diagnosed with lupus.
|
 |
|
How
is lupus diagnosed?
|
|
Diagnosis: Because many lupus symptoms mimic other
illnesses, are sometimes vague and may come and go, lupus can be difficult
to diagnose. Diagnosis is usually made by a careful review of a person's
entire medical history coupled with an analysis of the results obtained in
routine laboratory tests and some specialized tests related to immune
status. Currently, there is no single laboratory test that can determine
whether a person has lupus or not. To assist the physician in the
diagnosis of lupus, the American College of Rheumatology (ACR) in 1982
issued a list of 11 symptoms or signs that help distinguish lupus from
other diseases (see Table 2). This has recently been revised. A person
should have four or more of these symptoms to suspect lupus. The symptoms
do not all have to occur at the same time.
|
|
THE
ELEVEN CRITERIA USED FOR THE DIAGNOSIS OF LUPUS ERYTHEMATOSUS
|
|
Criterion
|
Definition
|
|
Malar
Rash
|
Rash
over the cheeks
|
|
Discoid
Rash
|
Red
raised patches
|
|
Photosensitivity
|
Reaction
to sunlight, resulting in the development of or increase in skin
rash
|
|
Oral
Ulcers
|
Ulcers
in the nose or mouth, usually painless
|
|
Arthritis
|
Nonerosive
arthritis involving two or more peripheral joints (arthritis in
which the bones around the joints do not become destroyed)
|
|
Serositis
|
Pleuritis
or pericarditis (inflammation of the lining of the lung or heart)
|
|
Renal
Disorder
|
Excessive
protein in the urine (greater than 0.5 gm/day or 3+ on test sticks)
and/or cellular casts (abnormal elements the urine, derived from red
and/or white cells and/or kidney tubule cells)
|
|
Neurologic
Disorder
|
Seizures
(convulsions) and/or psychosis in the absence of drugs or metabolic
disturbances which are known to cause such effects
|
|
Hematologic
Disorder
|
Hemolytic
anemia or leukopenia (white blood count below 4,000 cells per cubic
millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic
millimeter) or thrombocytopenia (less than 100,000 platelets per
cubic millimeter). The leukopenia and lymphopenia must be detected
on two or more occasions. The thrombocytopenia must be detected in
the absence of drugs known to induce it.
|
|
Antinuclear
Antibody
|
Positive
test for antinuclear antibodies (ANA) in the absence of drugs known
to induce it.
|
|
Immunologic
Disorder
|
Positive
anti-double stranded anti-DNA test, positive anti-Sm test, positive
antiphospholipid antibody such as anticardiolipin, or false positive
syphilis test (VDRL).
|
|
|
