Q: My 16-year-old daughter has had joint aches and a rash on both cheeks for quite some time; I finally took her to our doctor about it and was told she probably has lupus and ordered some blood tests. Is this serious?

A: Left unevaluated and untreated, it certainly can be serious. Systemic lupus erythematosus (SLE or lupus) is an autoimmune disease that is usually difficult to diagnose in the primary care setting because its symptoms are common and often attributed to other causes.

The most common presenting symptoms are fatigue, unexplained weight loss, and fever without an obvious cause, all of which generally occur in up to 90% of patients. Joint and muscle pain are reported in up to 95% of patients who are later shown to have lupus. The facial rash you describe is seen in about 1/3 of those later shown to have lupus, particularly in adolescent females. SLE is 10 times more common in females than males.

The best initial blood test is an antinuclear antibody (ANA) test, which is positive in about 94% of individuals with lupus, but can also be positive in other situations. Additional tests are usually ordered by a rheumatologist, a specialist in diseases of inflammation, who should be consulted in any case where lupus is strongly suspected.

Lupus is the 10th most common cause of death in women between the ages of 15 — 24 years, though fortunately, effective treatments are available when the diagnosis is properly confirmed.

To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website familydoctor. org, where you can click on the Search box in the upper right corner of the website, and enter your topic of interest.

Thanks to July T. for suggesting this topic; if you have a topic you would like to hear more about, please message me at paulmdake@gmail.com.

Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.