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Diagnosis of Systemic Lupus Erythematosus (SLE)

  • Cynthia M. Johnson, MA
Publication Type:

Condition InDepth

Diagnosis of Systemic Lupus Erythematosus (SLE)

SLE can be hard to diagnose because:

  • Symptoms are like many other health problems
  • There is no test
  • Each person with SLE may have different signs of it

It may be suspected if a person has at least four of these signs:

  • Butterfly rash over the cheeks and nose—a key sign
  • Rashes that can lead to scarring
  • Skin that gets burned easy in the sun
  • Sores in the mouth
  • Joint swelling, pain, and warmth
  • Inflammation of the lining of the heart
  • Seizures or psychosis

Changes in the blood and kidneys may be found through:

Blood Tests

SLE can cause changes in the blood. They differ from person to person, but may be:

  • Having antinuclear antibodies (ANA) that attack the body's cells
  • Signs of inflammation
  • Unusual findings from a blood cell measurement
  • Signs of substances that are normally filtered by the kidneys

Urine Tests

Proteins, blood, or other substances in the urine may point to a change in kidney function.


  • Guidelines for referral and management of systemic lupus erythematosus in adults. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Arthritis Rheum. 1999;42(9):1785-1796.
  • How is lupus diagnosed? Lupus Foundation of America website. Available at: http://www.lupus.org/answers/entry/diagnosing-lupus. Accessed September 4, 2018.
  • Lupus. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Lupus/default.asp. Updated June 30, 2016. Accessed August 31, 2018.
  • Systemic lupus erythematosus (SLE). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115873/Systemic-lupus-erythematosus-SLE . Updated July 20, 2018. Accessed August 31, 2018.
  • Systemic lupus erythematosus (SLE). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/autoimmune_rheumatic_disorders/systemic_lupus_erythematosus_sle.html. Updated February 2018. Accessed August 31, 2018.


  • Daniel A. Ostrovsky, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.