With NO apologies to Jimmy Moore, who thinks that a blah-blah-blah-is-stupid title is stupid. Well, welcome to Snarksville. I won't stop, and I also won't eat a stick of butter with a candle on top for my birthday. (I just got a copy of Dr. Davis' latest cookbook. Yay!)
Anyway, where was I?
I should have called this "Diagnosing Autoimmune Diseases 101", if I hadn't wanted to catch your attention. Here's how its done.
Go to the doctor for something. The trigger for the AI path can be just about anything, anything on the continuum from pain to having been in the hospital for a week with everything failing.
The first test is ANA. If this test is negative they can send you home, declare you a hypochondriac, or send you down some other path that may be just as stupid but won't be covered here.
If it is positive, they diagnose you with lupus.
Now, the reason that AI diseases are stupid is this. Just like what my med-school entry advisor told me: "Medicine is the only educational pursuit where they weed you out BEFORE you get into school." The AI playing field is the only one where they diagnose the VERY WORST condition first, and then back off from that as more data comes in.
Can you imagine if you go into the doc's office for a small growth and you get back a letter saying you have cancer, and then a few weeks later you get back a letter saying it was just a wart? Yep, not gonna happen.
So....you go home with the diagnosis of lupus and read all about it on the internet. People are all carrying on, and you know someone who's sister got it really bad and she dies at 29, and what will happen to the kids? You start to get really worried.
You go to take a bunch of other tests, around ten of them usually. You don't test for an immune reaction to EVERYTHING!, just the major stuff. Stuff that will indicate that your liver or kidneys will explode. Stuff that will tell if you have one of the major AI conditions or the other. They aren't as interested in splitting hairs if they think that either-or won't kill you.
If something else shows positive, they might move you from the deadly lupus diagnosis to something that sounds a bit better, like arthritis, Sjogren's or thyroid disease. Once you have your new diagnosis, they won't usually test you for all the little diseases unless you have really terrible symptoms that don't respond to treatments.
They'll send you to a rheumatologist, who will watch you every few months while you get better, worse, or stay the same. They might also send you to someone else to take care of other symptoms.
In my case, I got diagnosed with lupus, had it changed to "not-lupus" with secondary Sjogren's syndrome, to UCTD, to "positive ANA" and told I didn't have to come back. (BTW, UCTD is the catch-all disease-name for "we don't know WTF AI disease you have, but you're achey and its not that bad".)
The tests for celiac aren't included in the typical AI diagnosis panel. Stupid? Hmmmm.