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To have lupus a patient must have four out of eleven abnormalities from a list established by the American Rheumatism Association. These abnormalities are:

1. Malar rash

2. Discoid rash

3. Photosensitivity

4. Mucosal ulcers

5. Serositis

6. Arthritis

7. Renal disorders

8. Neurological disorder

9. Haematological disorder

10. Immunologic disorder

11. Anti-Nuclear Antibody The American College of Rheumatology established these 11 criteria as a means of determining whether or not a patient qualifies to enter lupus clinical trials. In the process of diagnosing lupus, these are helpful but not absolute, some criteria carrying more weight than others. For example, a kidney biopsy that confirms lupus nephritis determines a diagnosis of lupus whether or not any of the other 11 criteria are present. A skin biopsy that confirms cutaneous lupus is all that is needed to make that diagnosis as well. Lupus is diagnosed based on these steps and information: # Medical history # Symptoms # Wide variety of lab tests # After other disorders have been ruled out It should be noted that 10 million Americans have a positive Antinuclear antibody titer (ANA) but only 1.5 million have lupus. Of that 1.5 million with lupus, 5% will have a negative ANA titer. This, according to Daniel Wallace, MD in The Lupus Book.

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