Leading the way to a cure

Lupus Research Update: 2014 Volume 1

Volume 1, 2014 | In This Issue

Diagnosing Lupus: A Physician’s Point of View >
Lupus Research to Better Treat and Diagnose Patients >
The Unique Role of Rheumatologists >
A Loving Family Battles Lupus Together >
2014 ALR Grantees Announced >
Lupus News Corner >

Diagnosing Lupus: A Physician’s Point of View

Alana Levine, MD, is a young rheumatologist who possesses an ample amount of energy, compassion, and expertise. These are essential qualities when it comes to providing the best possible care for lupus patients at the Hospital for Special Surgery. From first-hand experience, Dr. Levine knows that skill and intuition play a huge part in diagnosing and treating lupus.

Lupus is a complex, mysterious disease. Periods of illness can be followed by periods of remission with barely a warning that skin, heart, joints, lungs or other parts of the body are being harmed. That's why Dr. Levine takes the time to understand what's going on with each of her patients before any treatment begins.

"When I see new patients, I tell them we're going to do a lot of blood and urine tests," said Dr. Levine. This is a critical first step to determine blood cell counts and kidney function to look for abnormalities. "I collect all this data to see if it meets criteria for a diagnosis of lupus," Dr. Levine added.

She takes the standard approach to look for four out of 11 criteria for lupus — but Dr. Levine knows diagnosing lupus is not that simple. "Sometimes people will present three of these criteria and have the disease. Or they can present six of the criteria but have a totally different disease," she explained.

Many of her referrals are from primary care physicians who ran ANA testing on patients suspected of having lupus. A positive ANA test means autoantibodies are present, which could signal the body to start attacking itself.

If any of her patients show severe symptoms of the kidneys, lungs, or heart, Dr. Levine will engage the expertise of a nephrologist, pulmonologist, or cardiologist. She believes that working collaboratively with specialists has the best possible outcome for patients.

But if a patient is flaring frequently, that is her territory: "I like to work with these patients to try and get the flares to subside. To alleviate pain and suffering is why I chose to go into the field of medicine."

Recognizing different patterns is critical — because every patient presents in different ways. "Not every patient follows the same sort of recipe for what the disease will look like," she said. "So it is about getting to know my patients... recognizing some of these patterns... and combining both the clinical manifestations with laboratory tests."

Even with treating lupus patients every day, lupus remains a challenge for physicians like Dr. Levine. She is quick to acknowledge that it can be very tricky to diagnose. "Many things can mimic lupus and vice versa," she said. "So if someone comes to see me, I take all the symptoms into account." Dr. Levine leaves little doubt that she has the best interests of all of her patients at heart.

1.5 million

people in the U.S. have Lupus.

172 million

dollars committed to lupus research by the Lupus Research Alliance.

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