Sorry, no results found
Routine tests
Because it causes a range of symptoms, lupus is often mistaken for other conditions, making diagnosis challenging.
What is lupus?
Lupus is an autoimmune disease where the immune system mistakenly attacks healthy tissues and organs. This can lead to inflammation affecting the skin, joints, kidneys, heart, lungs and other parts of the body.
Donna van Schalkwyk, who has been living with lupus for more than two decades, says one of the most difficult aspects of the condition is that many symptoms are invisible to others.
Diagnosed after initially being treated for what appeared to be an allergic reaction, she has learned to adapt to the unpredictable nature of the disease.
"Some days are manageable and some days are harder," she says. "What I wish people understood is that the pain, fatigue and swelling are real, even when they can't be seen."
Her experience highlights the reality that lupus affects each person differently, and that support and understanding can play an important role in helping people manage the condition.
Why lupus can be difficult to recognise
One of the biggest challenges with lupus is that its symptoms often resemble those of many other conditions. Joint pain, fatigue, skin rashes and fevers can all occur for reasons unrelated to lupus, which is why diagnosis is not always straightforward.
Unlike ordinary tiredness, lupus-related fatigue can affect a person's ability to work, socialise and carry out everyday activities.
Some people may experience symptoms for months before receiving a diagnosis, while others may only develop certain symptoms later in the course of the disease.
This variability is one of the reasons lupus is often described as a complex condition to diagnose and manage.
The condition affects people differently. Some people experience mild symptoms that can be managed effectively, while others may develop more serious complications that require ongoing medical care.
People aged 15–45, particularly women, are most commonly affected by lupus, although it can develop in anyone at any age.
Common signs and symptoms of lupus
The most common signs of lupus are joint pain, stiffness and swelling, along with skin changes such as the characteristic butterfly-shaped rash across the cheeks and nose.
Other symptoms may include:
- Recurrent oral ulcers
- Ongoing joint pain, stiffness or swelling
- A persistent facial rash or unexplained skin changes
- Fatigue that interferes with daily activities
- Unexplained fever
- Sensitivity to sunlight accompanied by skin reactions
- Chest pain or shortness of breath
- Swelling in the legs or around the eyes
- Changes in the appearance of your urine
- Pale or discoloured fingers and toes in response to cold
- Hair loss or thinning
How is lupus diagnosed?
"Lupus is diagnosed using a combination of clinical criteria and biochemical investigations," says Dr Yusuf Mohamed, Rheumatologist at Mediclinic Pietermaritzburg.
"While symptoms provide important clues, the diagnosis is confirmed through a detailed medical evaluation supported by blood tests and other investigations where necessary."
There is no single test that definitively diagnoses lupus. Instead, doctors consider a person's symptoms, medical history, physical examination findings and laboratory results together before making a diagnosis.
Patients have to fulfil a strict scoring criteria for a definitive diagnosis
Diagnostic investigations may include:
- Blood tests, including antinuclear antibody (ANA) testing and other autoimmune markers
- Full blood count to identify abnormalities that may be associated with lupus
- Urine tests to assess kidney function and detect signs of inflammation
- Kidney or skin biopsies in selected cases
- Imaging tests, such as chest X-rays or echocardiograms, where organ involvement is suspected
“While lupus may be a lifelong condition, advances in treatment mean that many people are able to successfully manage their symptoms, reduce flare-ups and maintain a good quality of life,” says Dr Mohamed.