Lupus is a chronic autoimmune disorder in which the immune system attacks healthy tissue throughout the body. Doctors use several steps and tests to diagnose the condition.

Lupus can be challenging for healthcare professionals to diagnose. The symptoms can be similar to those of several other, more common conditions. The symptoms may also change or go away and then come back.

No single test can confirm lupus. Instead, a doctor needs to go through a variety of steps and tests to determine whether a person has the condition.

This article reviews some of the common methods doctors use to diagnose lupus, treatment options for the condition, and when to see a healthcare professional.

A healthcare professional looking out a window 1Share on Pinterest
Santi Nuñez/Stocksy

One of the first steps to diagnosing lupus involves reviewing a person’s individual and family medical history.

A person may consider writing down some information about their symptoms to share with their doctor, such as:

  • what the symptoms are
  • how often they occur
  • when they started
  • what makes them get better or worse
  • whether they are constant or come and go
  • whether they interfere with daily routines
  • whether they are worse at certain times of the day

A doctor will likely ask the person whether they have a family history of lupus or other autoimmune disorders.

Healthcare professionals do not know exactly what causes lupus, and scientists have not linked a single gene to its development. Most cases appear sporadically, which means none of a person’s known relatives have lupus. The condition may occur due to a variety of factors, including genetics, environment, and hormones.

For example, having a family history of autoimmune disorders may increase someone’s chance of developing lupus. People with the following types of heritage may also have a higher risk of developing lupus:

  • Native American
  • Hispanic
  • African
  • Asian
  • Pacific Islander
  • Native Hawaiian

If a person has a family history of lupus or another autoimmune disorder, a doctor may further investigate their symptoms to work out whether lupus may be the cause.

Learn more about the role genetics play in developing lupus.

A person will often have a physical exam during the diagnostic process. Doctors may conduct a physical exam while reviewing someone’s personal and family medical history.

During the exam, the doctor will likely check for rashes and other potential signs of lupus. The discovery of rashes or other abnormalities does not mean a person definitely has lupus, but it could help a doctor determine whether lupus is a possible underlying cause.

There is no single biomarker or other indicator in blood or urine that points to lupus. However, blood and urine tests can help a doctor rule out other possible causes of symptoms.

A blood test requires a blood draw, which means a healthcare professional takes a sample of someone’s blood with a needle. They then send the sample to a lab for analysis. Doctors often order the following blood tests:

Urine tests may indicate whether a person’s kidneys are functioning as usual. A doctor may order several urine tests throughout the diagnosis and treatment process to monitor a person’s kidney function.

Biopsies involve healthcare professionals taking a small sample of tissue from an area of a person’s body and examining it under a microscope.

A doctor may perform a skin or kidney biopsy to check for potential indicators of lupus.

Lupus does not yet have a cure. Instead, treatment focuses on several aspects, including:

  • preventing or slowing organ damage
  • preventing, reducing, and stopping lupus flares
  • managing lupus symptoms
  • improving a person’s quality of life
  • maintaining the lowest level of disease activity or complete remission

Treatments primarily consist of several medications, which may include:

A doctor may also prescribe other medications to treat or prevent complications of lupus or side effects of the medications that treat lupus.

Research into whether complementary treatments may benefit people with lupus are limited and inconclusive. However, a person may wish to speak with a healthcare professional about complementary treatments that they may be able to use alongside medications or other prescribed treatments.

A person should discuss with a doctor any changes in medications, possible side effects, and other questions about their treatment options.

A person should consider consulting a doctor if they notice any potential lupus symptoms that are interfering with their daily life.

Since lupus can be difficult to diagnose, it can be beneficial for a person to provide the doctor with as many details as possible. A person should consider seeking a second opinion if a doctor does not find a cause of the symptoms and they continue to occur.

People with lupus should also speak with a healthcare professional about their treatment options and any potential side effects from medications. A doctor may be able to recommend alternative medications if needed.

Below are frequently asked questions relating to lupus diagnosis.

What are the 11 criteria for lupus?

The 11 criteria for lupus are:

  • Malar rash: A rash on the cheeks.
  • Discoid rash: Patches of rash with scales and blocked hair follicles.
  • Oral ulcers: Sores inside the mouth.
  • Photosensitivity: Sensitivity to sunlight.
  • Arthritis: This can occur in the joints and tendons.
  • Serositis: This is inflammation of the tissue surrounding internal organs.
  • Renal disorder: These are issues with the kidneys.
  • Neurologic disorder: Examples include seizures and psychosis.
  • Hematologic disorder: This can cause blood disorders.
  • Antinuclear antibodies: A test for these antibodies can determine whether or not a person has lupus.
  • Immunologic disorders: A doctor will check for these with antibody tests.

What are the warning signs of lupus?

Some warning signs of lupus include fatigue, pain, and rashes. People may also experience mouth sores and sensitivity to sunlight.

What is the main blood test for lupus?

As part of lupus diagnostic testing, doctors will often order a complete blood cell count to assess white and red blood cell levels and an antinuclear antibodies test (ANA test). According to the Lupus Foundation of America, around 97% of people with lupus test positive for ANA.

Is it MS or lupus?

Lupus and multiple sclerosis (MS) can present with similar symptoms, including fatigue and pains. However, there are key points of difference.

In MS, the immune system attacks the central nervous system, causing pain, whereas in lupus, the immune system attacks tissues directly.

Lupus often causes rashes, mouth sores, sun sensitivity, and kidney problems, while these symptoms do not occur in MS. MS can cause electric shock sensations, vision issues, and speech changes. These do not occur in lupus.

What tests are done to diagnose lupus?

Doctors will order or carry out several different tests to diagnose lupus and rule out other similar conditions. These include:

  • physical exams
  • history assessments
  • urine analysis
  • complete blood counts and other blood tests
  • biopsies

What level of ANA indicates lupus?

A positive ANA result can indicate lupus, among many other conditions. This test alone is not enough to diagnose the condition. A person should follow up with their healthcare provider to discuss all lab results.

Lupus is often difficult to diagnose.

There is no single test to check for it, and many of the symptoms are similar to those of other conditions. A person may need to visit multiple doctors before they receive a diagnosis.

The diagnostic process typically involves several steps such as a physical exam, a review of personal and family medical history, and a range of lab tests. Blood tests, urine tests, and biopsies may help healthcare professionals identify signs of autoimmune reactions and rule out other conditions.

A person should speak with a doctor if they think they may be experiencing symptoms of lupus or if they have received a lupus diagnosis and wish to know more about their treatment options.