Lupus presents several challenges

"In soft forms of the disease, symptoms usually present so confusing," says Wofsy. "Someone comes in who is young with a variety of nonspecific symptoms, and a doctor cannot be thinking about Lupus. The person may complain about feeling tired in the afternoon or about feeling achy. A doctor might think that these symptoms may be due to stress or depression or a virus. "

One of the things more frustrating for someone with Lupus is being sick, but feeling like nobody believes you, says Ramirez. "People think that you are lazy or crazy, or both," she says. "You can also look nice and healthy, even if you feel too bad."

Before she was diagnosed with lupus, Ramirez fought mysterious symptoms for 10 years. She had five miscarriages and later discovered that women with Lupus have higher rates of pregnancy loss. She also had:

unexplained skin rashesanemiapain in his legs and fatigue soresoverwhelming armsurinary infectionsfeversmouth infectionskidney tract

In an unpublished study done in 1999, Isenberg and his colleagues asked 100 patients of lupus that they were more concerned about his illness. Isenberg "the biggest concern was fatigue," he says. "They were concerned about sleep all night and still runs out in the morning or feeling too tired to pick up their children from school or do other things that they want to do".

As a former police and members of the armed forces, Tony Chisholm, 46, of fall city, Washington, was used to be active. Feeling wiped out Lupus sent him into a deep depression. "I could only get out of bed," he says. "But nothing would appear in a physical examination."

He also has had bouts of flu symptoms, swelling around the eyes, pain in joints and chest pain. "Sometimes, the symptoms last for four months, and then I could go four months without any problems," he says.

It was a photograph that finally helped Chisholm get some answers. In 1997, he and his family were to Britain for holiday homes in met another couple. The couple sent Chisholm a photo of the journey. "The Red Butterfly rash on my face was clear as day," he says. "My wife insisted we go to the doctor". After looking at the photo, the doctor ran tests for Lupus. "Before that, I had not been diagnosed with anything else, except maybe hypochondriasis."

Early detection of Lupus is important to reduce the chance of organ injury and other complications. Doctors rely on:

report of a patient's medical history and symptomsa examblood and urine tests

"Lupus can decrease blood counts and affect the kidneys, causing protein and blood in the urine," says Petri. Doctors also can make skin biopsies or kidneys, in which tissue is removed and examined for signs of autoimmune disease.

A test commonly used for Lupus is the test of anti-nuclear antibodies (ANA), which looks for antibodies that react against the core, also known as the command center of body cells. "Most people with Lupus have a high ANA, although some rare patients have a negative ANA", says Petri. But a positive ANA is not sufficient to confirm lupus. "Twenty percent of healthy women can have a positive ANA," she says. The ANA also detects other autoimmune diseases, including:

Arthritis, Sjögren's syndromesclerodermarheumatoid

So if the ANA test is positive, more specific tests is used to confirm a diagnosis of Lupus. Doctors test components of the add-on, a group of blood proteins that help to destroy bacteria. Low levels complement can be associated with lupus. Doctors also do blood tests for antibodies to DNA and other nuclear components of the cell. Two specific tests for Lupus are:

the antibody test (anti-Sm) double-stranded DNA (anti-dsDNA) antibody testthe Smith

"Lupus is a disease is unpredictable, but certain antibodies help make some predictions," says Petri. For example, people with anti-dsDNA or add-on of bass are more likely to develop kidney disease, "she says. And some women with Lupus have a syndrome in which Antiphospholipid antibodies cause blood clots. This syndrome is associated with miscarriages, strokes, and deep venous thrombosis.

The American College of Rheumatology says that to be diagnosed as having Lupus, a person must meet four at least of clinical procedures and laboratory criteria:

eruption on cheekred, photosensitivityulcers relief patches (discoid rash) on the nose or moutharthritis (nonerosive arthritis in which the bones around the joints do not become destroyed) inflammation of the lining of the heart or lung (pleurisy and pericarditis) kidney disorder (excessive protein in the urine or cellular casts or both) neurological disorders (such as convulsions, seizures or psychosis) positive blood (hematologic) disorders (such as blood cells counts down repeated) ANA testimmunologic disordersRelated DiseaseRelated-resources-Lupus DiseaseRelated-features Lupus Lupus Disease