The diagnosis of lupus is usually made by clinical history and physical examination and some routine blood tests like blood counts, chemistries and urinalysis. The ANA test is used to confirm the diagnosis. Nearly always, it is positive in lupus (that means a level greater than 1:320). IF that is positive, the rheumatologist will often get additional tests like anti-Smith, anti-DNA, complements, etc. because these will mark a patient who is more likely to get kidney involvement and have a bit more severe disease.