What are the main signs and symptoms you look for when considering a diagnosis of lupus?
A – Lupus is an inflammatory process, so we look for signs of inflammation. It may be present on examination with swollen joints, rashes, vasculitis, etc. Many times it is only present on laboratory testing such as a sedimentation rate, CRP, high anti DNA or low C3. Sometimes patients with prominent aching and concurrent fibromyalgia can have a lupus like process made clear by obtaining a bone scan. This imaging technique lights up the hands and feet in most lupus patients and provides evidence for inflammation. Fibromyalgia is a non-inflammmatory process. Q – I often get emails from people who have negative blood tests (e.g. ANA, anti-ds DNA), and have therefore been told that they have not got lupus. What are your thoughts on this matter, does a negative test on one occasion necessarily mean that lupus can be ruled out? A – ANA negative lupus is only seen in discoid lupus, antiphospholipid syndrome and patients who have had so much steroids or chemotherapy that their test becomes neg
