Medical History and Physical Exam for Lupus
Exam Overview
A physical exam for suspected
lupus (systemic lupus erythematosus, or SLE) includes
a thorough check of your skin, joints, lungs and breathing, nervous system, and
heart.
The medical history includes questions about:
- Arthritis,
joint, or muscle pain.
- Weight loss or fatigue.
- Skin
rashes, especially after exposure to sunlight.
- Sores in the mouth,
nose, or other mucous membranes.
- Chest pain.
- Hair loss
or thinning.
- Seizures, convulsions, or other
nervous system symptoms.
- Whether anyone in
your family has lupus.
- Whether you have ever had kidney
disease.
Why It Is Done
A physical exam and medical
history are done to evaluate symptoms. The parts of the body that are examined,
and the questions that are asked, depend on which diseases your doctor suspects
or thinks are most likely.
Results
Your doctor will use certain criteria to
distinguish lupus from other
autoimmune and rheumatic diseases. You may have all of
the lupus-related conditions at once, or you may experience them over a period
of time.
Classification criteria for systemic lupus
erythematosus:1
- Butterfly (malar) rash on
cheeks
- Rash on face, arms, neck, torso (discoid
rash)
- Skin rashes that result from exposure to sunlight or
ultraviolet light (photosensitivity)
- Mouth or nasal sores (ulcers), usually painless
- Joint swelling,
stiffness, pain in two or more joints (arthritis)
- Inflammation
of the membranes surrounding the lungs (pleuritis) or heart (pericarditis)
- Abnormalities in urine, such as increased protein or
clumps of red blood cells or kidney cells, called cell casts
- Nervous system problems, such as seizures or
psychosis, without known cause
- Problems
with the blood, such as reduced numbers of red blood cells (anemia), platelets,
or white blood cells
- Laboratory tests showing increased
autoimmune activity (antibodies against normal
tissue)
- Positive antinuclear antibody (ANA) test
If you have at least 4 of these 11 conditions, you
likely will be classified as having lupus.
What To Think About
Lupus is hard to diagnose, because
its symptoms are similar to those of many other disorders. A few nonspecific
symptoms may persist for years before other problems develop.
When
classic lupus symptoms develop quickly, lupus can be more easily diagnosed. If
the symptoms are nonspecific or occur off and on, or if test results are
inconclusive, it may take months or even years to make a definite
diagnosis.
Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.
References
Citations
- Hahn BH (2012). Systemic lupus erythematosus. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 2724–2735. New York: McGraw-Hill Medical.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology |
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| Last Revised | May 10, 2012 |
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Last Revised:
May 10, 2012
Hahn BH (2012). Systemic lupus erythematosus. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 2724–2735. New York: McGraw-Hill Medical.
