Official Diagnostic Criteria for SLE + Differenti... - LUPUS UK

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Official Diagnostic Criteria for SLE + Differential Diagnosis

Barnclown profile image
Barnclown
โ€ข22 Replies

๐Ÿ™‹๐Ÿผโ€โ™€๏ธ Hello my lovelies...there has been a lot more discussion here about diagnostic signs, symptoms, manifestations & official diagnostic criteria. This official chart is a great reference, so thought iโ€™d just pop it on for anyone interested (as youโ€™ll see when you study it: seronegativity alone doesnโ€™t necessarily mean you fail to meet official diagnostic criteria). One of the most expert rheumatology consultants at my univ hospital lupus clinic showed us this chart during a talk she gave our LUK local support group not long ago

Of course, the LUK website includes great info on all of this:

lupusuk.org.uk

I also like this website because its SLE diagnosis info is very precise and comprehensive (covers signs, symptoms & manifestations), + it clearly & concisely explains the SLICC official diagnostic criteria AND gives solid info on differential diagnosis....including the lupus-like connective tissue disorders + sjogrens + rhups etc etc:

uptodate.com/contents/diagn...

๐Ÿ€๐Ÿ€๐Ÿ€๐Ÿ€ coco

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Barnclown profile image
Barnclown
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22 Replies
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sunshine16 profile image
sunshine16

Thank you once again Coco for your wonderful input you really are a fantastic addition to this forum ๐Ÿ˜Š๐Ÿ˜ŠI have been a bit quiet on here because I haven't felt well and just popping in periodically

really appreciate everything and all the time and effort you put into Your research and support you give to us on this forum

have a good day very best wishes๐Ÿ’๐Ÿ’๐Ÿ’

Barnclown profile image
Barnclown in reply to sunshine16

๐Ÿ˜โ˜€๏ธ so glad to see you! Youโ€™re v welcome! Reviewing this info does me good too ๐Ÿ˜‰! Hope youโ€™re feeling more โ€œOKโ€ soon. ๐Ÿ€๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜

misty14 profile image
misty14

Thank you so much Barnclown for posting this helpful and interesting info!. Couldn't do without you as this is great outlining the explanation of UCTD and how it should be monitored!. I'm particularly interested in the 40-60 % category whose tests haven't changed over the years!. That's a high % don't you think Barnclown?. It's heartening that it can happen as I'm in that group!. I bet you have found this info helpful for yourself!. Thank you for sharing and good luck for tomorrow. Fingers tightly crossed X

Barnclown profile image
Barnclown in reply to misty14

Am delighted this is really useful to you ๐Ÿ˜†....yes: i felt as if iโ€™d Hit The Jackpot when i found uptodate.com ๐ŸŒŸ๐ŸŒŸ๐ŸŒŸ๐ŸŒŸ. Youโ€™re v welcome ๐Ÿ˜˜๐Ÿ€

ExtremeDuvetDaze profile image
ExtremeDuvetDaze

Hello Coco. Thanks for sharing this up to date info, it makes it all a bit clearer doesnโ€™t it and you put this up at the right time for me as I had my rheumy appt last week and although he mentioned me being on the โ€˜lupus spectrumโ€™ he talked about CREST as he had done at my previous appt, I asked him if I was still in the UCTD category and he said no! he said I have CREST (limited Systemic Sclerosis) , Iโ€™ve just received a copy of the Gp letter and the diagnosis is SLE......Iโ€™m so confused๐Ÿ˜ฉ!

After reading the differential diagnosis section Ssc Iโ€™m wondering if he meant I have SLE and overlapping Ssc!

Just when I start to get my head around a diagnosis it seems to change! ๐Ÿ™„

I hope things are going ok for you.

Big Hugs

Diane xx๐ŸŒธ๐Ÿ˜˜๐ŸŒป๐ŸŒž

Barnclown profile image
Barnclown in reply to ExtremeDuvetDaze

๐Ÿ˜Ÿ Oh Diane....YIKES! I wonder if they have any idea how much this sort of thing unsettles us! I โค๏ธ that youโ€™ve been able to use that link to winkle something sensible out of this letter๐Ÿ‘๐Ÿ‘๐Ÿ‘๐Ÿ‘...i bet youโ€™re right: itโ€™s an SLE/Ssc overlap thing! Am v much feeling for you...processing these appts is such an ordeal ๐Ÿ˜”. Iโ€™ll be processing my next rheumatology appt later this month....am โ€œtryingโ€ to stay calm & positive ๐Ÿ˜ ๐ŸŒˆ๐Ÿ•Š๐Ÿ’๐Ÿ€๐Ÿ˜˜

ExtremeDuvetDaze profile image
ExtremeDuvetDaze in reply to Barnclown

Good luck for your rheumy appointment too Coco, I try and be prepared but I always manage to miss something outโ˜น๏ธ! Iโ€™ve now had Azathioprine added to my list of drugs and he gave me a depo shot so I know whatever the diagnosis Iโ€™m being listened to and getting help, fingers crossed itโ€™ll help.

All the best ๐Ÿ˜˜๐Ÿ’๐Ÿค—๐ŸŒธxx

Barnclown profile image
Barnclown in reply to ExtremeDuvetDaze

๐Ÿฅ‚๐Ÿพ๐Ÿ˜Š๐Ÿ‘๐Ÿ‘๐Ÿ‘๐Ÿ‘๐Ÿ˜˜๐ŸŒท๐Ÿ€

Penelope-Mary profile image
Penelope-Mary

Thank you Coco!! As always, top notch knowledge to reassure us that we are not going mad!

Youโ€™re a gem ๐Ÿ’Ž

PM

๐ŸŽ€

Barnclown profile image
Barnclown in reply to Penelope-Mary

๐Ÿ˜‚๐Ÿ˜‚๐Ÿ˜‚๐Ÿ˜‚ EXACTLY! ๐Ÿ˜ THANKS PM

I especially LOVED this uptodate linkโ€™s document when i got to this para on p9...i thought: OK๐Ÿ‘Œ๐Ÿ‘๐Ÿ’ชโœŒ๏ธ thatโ€™s my seronegativity explained yet again (immunology, gastroenterology, rheumatology have all given me their explanations, but finding their reasoning corroborated in a document of this scope, precision, seriousness & establishment sanction is ๐Ÿคฉ...๐Ÿคท๐Ÿผโ€โ™€๏ธ HEAVENS: the lead authour credit on 1 goes to our HERO Daniel J Wallace MD, authout of The Lupus Book & The Sjogrens Book...and the doc was last updated in Sept 2017 ๐Ÿค—):

โ€œOther factors that may also influence ANA negativity in SLE patients include disease duration and treatment exposure [27]. In our experience, the frequency of ANA-negative SLE is lower in patients presenting at an early stage of their disease. In addition, SLE patients who have longstanding disease and/or have undergone treatment may lose ANA reactivity and become serologically negative over time.โ€

๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€

Penelope-Mary profile image
Penelope-Mary in reply to Barnclown

Youโ€™re amazing ๐Ÿ‘๐Ÿผ, thereโ€™s a damn good book in you dearest Coco xx

Barnclown profile image
Barnclown in reply to Penelope-Mary

๐Ÿ˜ฌ am too shy for that ๐Ÿ˜‰

This morning i was messing around on the uptodate website and dscovered you actually need to pay a subscription fee to access these documents...not sure how i managed to find & post the link that is getting us into the document without paying a subscription ๐Ÿคท๐Ÿผโ€โ™€๏ธ...but i certainly am willing to pay for access now i know how good this websiteโ€™s downloadable material is! ๐Ÿค—๐Ÿ˜˜

Penelope-Mary profile image
Penelope-Mary in reply to Barnclown

Do it. When you think of money wasted, this just isnโ€™t . Knowledge is power.

๐ŸŽ“๐Ÿ‘๐Ÿผ๐Ÿ‘Œ๐Ÿผ

Barnclown profile image
Barnclown in reply to Penelope-Mary

Too True...the sub fees cover something like either 2 days of access or 7 days...and the amounts seem fair to me! ๐Ÿ˜Š

katidid profile image
katidid

Thanks for posting, really helpful! Do you know where the malar rash falls or if thatโ€™s not actually part of the criteria?

Barnclown profile image
Barnclown

Youโ€™re v welcome, katidid

Good question! The answer seems to be as complex as Lupus itself....as far as i can make out, this is the sort of answer โ€˜thoughtfulโ€™ medics might offer:

Malar rash is one of those โ€œtricky bitsโ€ of diagnostic evidence. Possibly the significance of malar rash is best addressed most directly by approaching it the way itโ€™s mentioned on p6 of the uptodate link document under the heading: classification. E.g. history (eg with photo evidence, or actual current evidence on physical examination) of photosensitive skin lesions such as malar rash are considered amongst clinical manifestations as โ€œsigns & symptomsโ€ + โ€œpertinent physical examination findingsโ€ of SLE (see p 2 & 3 of the uptodate link document) which are all part of the considerations that convince consultants to proceed with performing the lab tests & imaging investigations that can yield results fulfilling official SLICC srteria

So malar rash can be very relevant to diagnosis , but is not specifically listed as an official SLICC criteria in its own right

All of which, for what itโ€™s worth, i think, backs up the uptodate documentโ€™s assertion that: SLE is tough to diagnose... so consultants with special, significant, substantial, full-on etc etc lupus expertise are best placed to undertake diagnosis (not some GP, or some dermatologist or some rheumatologist whose career has mainly involved caring for rheumatoid arthritis patients. Etc etc)

Hope that makes some sort of sense ๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€

ToryO profile image
ToryO

Barnclown, ๐ŸŒ  a wealth of info you share on this sight. 20 yrs ago, in 30s I was clinically diagnosed with ANA RA Ssa SsB and felt great. Over the years, Iโ€™ve collected additional โ€œfriendsโ€ antiphosphis lipids; Lupus sle, hair loss ... bald for a while. As a homeopathic woman , not vegan... I fought prednisone with no luck w a rheumatologist I stayed w too long.. last flare so frightening,

The pain in hand, feet and head worse than kidney stones. Cognitive function was ziltz.. thought I lost my dog.. and balance poor.. Iโ€™m a good yogi. Three days, ice, ice; sweat and Dr only increase prednisone 50mg and offer opiates pain. Finally husband flew home. H20 and cucumber.. some crackers.. enough!

New Rheumy.. with osteoporosis and inability to convince old Dr. Of anything but RA.. time to get a grip๐Ÿ‘ New Dr. Is well informed. Hoping positive. You have great and supportive group.

So very ๐ŸŒฟ๐ŸŒฟmuch appreciated. ๐Ÿ˜Žur rockstar!

Barnclown profile image
Barnclown in reply to ToryO

Hello Toryo! Glad youโ€™ve found our wonderful forum: the info sharing & solidarity here are lifesavers! And your experience of autoimmune disease will help lots of us here too. Am very sorry things are extra tough for you now, and am v glad youโ€™ve found a up to date new Dr ๐Ÿ‘๐Ÿ‘๐Ÿ‘๐Ÿ‘. Hope youโ€™ll let us know how things go for you ๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€

Wendy39 profile image
Wendy39

Thank you! Brilliant post!

This will be extremely helpful to many that are here fighting for a diagnosis and it relevant to my trip to London Bridge tomorrow/Friday.

Thank you for your very valuable input, as always.

Wendy xxx

Barnclown profile image
Barnclown in reply to Wendy39

Gosh: hope youโ€™ll let us know how your trip went!

This discussion helped me a lot too: am so glad you found it, Wendy! ๐Ÿ€๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜๐Ÿ€๐Ÿ˜˜

Wendy39 profile image
Wendy39 in reply to Barnclown

You know me, I'll post as soon as I can. Take care. xxx

Barnclown profile image
Barnclown in reply to Wendy39

๐Ÿค— Counting on you! โค๏ธ๐Ÿ€

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