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Diseases » Lupus » Misdiagnosis

Misdiagnosis of Lupus

Misdiagnosis of Lupus

A diagnosis of lupus may be delayed or missed because some cases are mild and have minimal symptoms and long periods between flare-ups of symptoms. In addition, many symptoms of lupus, such as fever, painful, swollen joints, rashes from sun exposure, hair loss and mouth lesions, can be attributed to a wide variety of other conditions or diseases. These include canker sores, aging, influenza, arthritis, joint overuse, sunburn, infections or stress.

There is also no specific test to diagnose lupus. Because of these factors, making a diagnosis of lupus can be difficult. A diagnosis is based on the complete compilation and evaluation of the patient's history, symptoms, exam, and multiple medical tests that rule-out other diseases and reveal indicators of lupus and its complications. These include kidney damage, liver damage, problems with the clotting of blood, heart damage, and lung damage....more about Lupus »

Lupus misdiagnosis: Lupus was cited by Reader's Digest as one of the top 10 misdiagnosed diseases. In the article entitled "10 Diseases Doctors Miss", the 10 diseases mentioned were hepatitis C, lupus, celiac disease, hemochromatosis, aneurysm, Lyme disease, hypothyroidism (underactive thyroid), polycystic ovary syndrome (PCOS), chlamydia, and sleep apnea. 1...more about Lupus »

Alternative diagnoses list for Lupus:

For a diagnosis of Lupus, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Lupus:

Diseases for which Lupus may be an alternative diagnosis

The other diseases for which Lupus is listed as a possible alternative diagnosis in their lists include:

Lupus: Hidden Causes Misdiagnosed?

Causes of Lupus may include these medical conditions:

  • There are 38 known medications to cause DIL but there are three that report the highest number of cases: hydralazine, procainamide, and isoniazid
  • more causes...»

Rare Types of Lupus:

Lupus: Medical Mistakes

Related medical mistakes may include:

Lupus: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Discussion of diagnosis/misdiagnosis of Lupus:

Lupus may be hard to diagnose. It's often mistaken for other diseases. For this reason, lupus has been called the "great imitator." The signs of lupus differ from person to person. Some people have just a few signs; others have more. (Source: excerpt from The Many Shades of Lupus: NIAMS)

Common Misdiagnoses and Lupus

Lupus is often misdiagnosed as other conditions: Systemic lupus erythematosus (SLE), often simply called "lupus", is a difficult disease to diagnose and can manifest with numerous symptoms. Some of the possible misdiagnoses include depression, bipolar disorder, anorexia nervosa, chronic fatigue syndrome, fibromyalgia, schizophrenia (a less common manifestation of lupus with hallucinations and/or delusions), conversion disorder, somatization disorder, hysteria and other diagnoses. See the overview of lupus or symptoms of lupus.

Cluster of diseases with difficult diagnosis issues: There is a well-known list of medical conditions that are all somewhat difficult to diagnose, and all can present in a variety of different severities. Diseases in this group include multiple sclerosis, lupus, Lyme disease, fibromyalgia, thyroid disorders (hypothyroidism or hyperthyroidism), chronic fatigue syndrome, diabetes - all of these can have vague symptoms in their early presentations. Also, depression can have some symptoms similar to these conditions, and also the reverse, that many of these conditions can mimic depression and be misdiagnosed as depression.

Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer's, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30's and 40's. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

Rare type of breast cancer without a lump: There is a less common form of breast cancer called inflammatory breast cancer. Its symptoms can be an inflammation of the breast tissue, such as with a breast rash with redness and warmth, but not necessarily a physical breast lump. This type of breast cancer should be considered as an uncommon possibility for certain types of breast symptoms.

Tremor need not be Parkinson's disease: There is the tendency to believe that any tremor symptom, or shakiness, means Parkinson's disease. The reality is that there are various possibilities, such as benign essential tremor, which is mostly harmless. see the various causes of tremor and misdiagnosis of Parkinson's disease.

Rare diseases misdiagnosed as Parkinson's disease: A rare genetic disorder is often misdiagnosed as Parkinson's disease for men in their 50's. The disease Fragile X disorder can show only mild symptoms in the early years, and Parkinsons-like symptoms around age 50. See misdiagnosis of Parkinson's disease.

Psoriasis often undiagnosed cause of skin symptoms in children: Children who suffer from the skin disorder called psoriasis can often go undiagnosed. The main problem is that psoriasis is rare in children, and not often seen by physicians for this reason. children may receive treatment for fungal skin infections. See misdiagnosis of psoriasis or symptoms of psoriasis.

Lupus: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Lupus

Failure to diagnose Lupus may be associated with the following:

  • Lupus may be difficult to diagnose because the condition can go into periods of remission where symptoms disappear. Symptoms may also be vague or mimic other illnesses
  • There is no conclusive test that can be used to diagnose lupus which means that it often takes months or years to diagnose
  • The range of lupus symptoms and progression can vary considerably which makes it more difficult to diagnose. Symptoms can affect virtually any part of the body so the range of possible symptoms is extensive. Some sufferers only have tiredness, skin rashes and joint pain which could occur as a result of other conditions
  • Coexisting autoimmune disorders such as rheumatoid arthritis may make lupus more difficult to diagnose
  • Delayed diagnosis of lupus may lead to further damage to the brain, spinal cord or body organs
  • Systemic lupus erythematosus is often dismissed as a potential diagnosis in children as it is generally considered an adult disease
  • Fatigue and malaise in children and adolescents is often ignored or considered harmless even though it is the most common symptom of systemic lupus erythematosus in children
  • Many health professionals do not consider systemic lupus erythematosus if a characteristic butterfly-shaped facial rash is not present even though the rash only occurs in about a third of the cases
  • Some patients present with mild, non-specific symptoms whereas other have more severe, progressive symptoms

Notes On Hidden Causes Of Lupus

The following may be hidden causes of Lupus:

  • Drug-induced lupus may be caused by drugs such as hydralazine, captopril, phenytoin, minocycline, nitrofurantoin and procainamide
  • There is no definitive cause determined for lupus as it occurs as a result of an immune system malfunction. Some people may be genetically predisposed to lupus which certain environmental factors triggering the disease. Triggering factors include infections (viruses, cytomegalovirus, EBV and retroviruses), antibiotics, ultraviolet light, hormones, certain drugs, chemicals (pollutants, toxins and hairspray) and severe stress
  • The contraceptive pill and hormone replacement therapy can trigger flare-ups
  • Researchers believe that females are more prone to developing lupus due to hormonal factors

Notes On Wrong Diagnosis Of Lupus

Wrong diagnosis of Lupus may be associated with the following:

  • Lupus may be wrongly diagnosed as chronic fatigue, schizophrenia, bipolar disorder or depression

Complications Of Misdiagnosis Of Lupus

The following may be complications of misdiagnosis of Lupus:

  • Weight loss, fever and swollen lymph glands associated with lupus may be mistaken as being caused by cancer
  • Tiredness associated with lupus may be mistaken as being caused by diabetes, anemia, underactive thyroid glands and fibromyalgia
  • Neurological symptoms caused by lupus may be misdiagnosed as epilepsy or schizophrenia
  • Joint pain due to lupus may be misdiagnosed as arthritis
  • Mastitis in a lupus patient may be misdiagnosed as a breast tumor
  • Chronic organic encephalopathy caused by lupus may be misdiagnosed as degenerative dementia
  • Conditions such as autoimmune haemolytic anemia and ITP may occur independently or as a result of SLE
  • Chronic fatigue caused by lupus may be misdiagnosed as a sleep disorder, depression, myopathy, electrolyte disturbance and pulmonary insufficiency
  • Neurological symptoms caused by lupus may be misdiagnosed as a movement disorder such as parkinsonism, chorea an ataxia
  • Fatigue and malaise in children may be misdiagnosed as being caused by an infection or cancer or may simply be dismissed as the child's excuse for not going to school. A reduced white blood cell count or platelet count may indicate SLE or Leukemia
  • The characteristic rash associated with rosacea or dermatomyositis is sometimes misdiagnosed as lupus
  • Arthritis and a positive ANA test may indicate SLE or it may be caused by Lyme disease or juvenile rheumatoid arthritis
  • A syndrome involving fever, rash, adenopathy and cytopenia caused by SLE may be misdiagnosed as an infectious disease such as HIV, mono nucleosis, bacterial endocarditis and cytomegalovirus
  • A syndrome involving acute polyarthritis, rash and cytopenia caused by SLE may be misdiagnosed as a viral infection such as heptatits, parvovirus and rubella. The same symptoms may also indicate blood cancer, lymphoma, leukemia and myelodysplastic syndrome
  • Nephritis due to SLE may be misdiagnosed as post-streptococcal glomerulonephritis, toxaemia, Goodpasture disease and genetic kidney diseases

Other Notes On Misdiagnosis Of Lupus

  • A third of people with lupus also have another autoimmune disease such as Sjogren's syndrome, antiphospholipid antibody syndrome and autoimmune thyroid problems. Rheumatoid arthritis and muscle inflammation may also coexist
  • Some patients develop lupus-like symptoms as well as symptoms of other disorders such as rheumatoid arthritis, scleroderma or dermatomyositis but lupus cannot be definitively diagnosed. These cases are labelled as undifferentiated connective tissue disease

Medical news summaries about misdiagnosis of Lupus:

The following medical news items are relevant to misdiagnosis of Lupus:

Misdiagnosis and Lupus deaths

Lupus is a condition that can possibly be deadly if misdiagnosed...more »

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Lupus or confirming a diagnosis of Lupus, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Lupus may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Lupus. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.

1. Reader's Digest, February 2004, "10 Diseases Doctors Miss", page 120

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