Diagnosis of Systemic Lupus Erythematosus

AAFP evidence-based review of SLE diagnosis reporting the ACR recommendation to order ANA only in patients with two or more unexplained organ-system signs, and the College of American Pathologists guideline on follow-up testing after a positive ANA. Candidate notes: ACR recommends ANA testing only in patients with two or more unexplained signs or symptoms; not indicated for isolated myalgias or arthralgias Persistently negative ANA (<1:40) can usually be assumed to rule out SLE; ANA was positive in 32% of the general population at 1:40 dilution but only 5% at 1:160 CAP guideline: if diagnostic criteria are met plus positive ANA, no further labs are needed; otherwise test anti-dsDNA and anti-Sm and do not test other autoantibodies Limits noted in the record: Dated 2003: predates the EULAR/ACR 2019 criteria and the ANA-as-entry-criterion framework Reports ACR/CAP guidance rather than generating original recommendations A positive ANA is not a diagnosis. Claims in this record are not verified.

A positive ANA is not a diagnosis. Claims in this record are not verified.

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