Symptoms:

Additional symptoms that may be associated with this disease:

• blood in the urine
• coughing up blood
• nosebleed
• swallowing difficulty
• skin color is patchy
• red spots on skin
• fingers that change color upon pressure or in the cold
• numbness and tingling
• mouth sores
• hair loss
• abdominal pain
• visual disturbance

Signs and tests:

The diagnosis of SLE is based upon the presence of at least four out of eleven typical characteristics of the disease.

Tests to determine the presence of these disease manifestations may vary, but will include some of the following:

• antinuclear antibody (ANA) panel including anti-DNA and anti-Smith antibodies, with the latter two tests generally positive in lupus alone
• characteristic skin rash or lesions
• chest x-ray showing pleuritis or pericarditis
• listening to the chest with a stethoscope to reveal heart friction rub or pleural friction rub
• urinalysis to show blood, casts, or protein in the urine
• CBC showing a decrease in some cell types
• kidney biopsy
• neurological examination

This disease may also alter the results of the following tests:

• WBC count
• serum globulin electrophoresis
• rheumatoid factor
• urine protein
• serum protein electrophoresis
• mononucleosis spot test
• ESR
• cryoglobulins
• Coombs' test - direct
• complement component 3 (C3)
• complement
• antithyroid microsomal antibody
• antithyroglobulin antibody
• antimitochondrial antibody
• anti-smooth muscle antibody

References:

Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005.

Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.

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