Lupus is chronic, complex, and difficult to diagnose. No single lab test can tell if you have lupus. Many lupus symptoms imitate symptoms of other diseases and often come and go. Your primary care doctor or rheumatologist will use your medical history, a physical exam, and many routine as well as special tests to rule out other diseases. Many physicians also use the American College of Rheumatology's "Eleven Criteria of Lupus" to aid in the diagnosis of lupus. The criteria include symptoms as well as specific laboratory findings that provide information about the functioning of a person's immune system. In most cases, the diagnosis of lupus is made when four or more of the criteria have occurred at some time.
If you have a positive antinuclear antibody (ANA) test, it does not automatically mean you have lupus. Your immune system is your body's natural defense against disease. A positive ANA blood test shows that your immune system is making an antibody (protein) that reacts with components of your body's cells. This is called autoimmunity and may or may not be harmful to your body. While a positive ANA may be associated with an autoimmune illness like lupus, it does not mean you have the disease. Approximately 20% of the normal population will have a positive ANA test; positive tests are also seen in other conditions, such as thyroid disease, certain liver conditions, and other autoimmune diseases. Before making a diagnosis, your doctor should be able to find objective physical or laboratory evidence of the condition, such as swelling of your joints, protein in your urine, fluid around your lungs or heart, or a positive skin biopsy.
For many lupus patients, following their doctors' instructions very carefully is the first step in the right direction. While lupus can be disruptive to everyday life and even life-threatening, the good news is that, with the correct medication and a healthy lifestyle, many lupus patients can enjoy an improved quality of life.
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