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Old 01-10-2006, 03:02 PM   #1
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Has anyone heard of the ortho evra patch causing lupus like symptoms?

If anyone has any information regarding lupus like symptoms and the ortho evra patch it would be greatly appreciated. Two months ago my daughter developed lupus like symptoms...the butterfly rash, joint swelling and pain, so I took her to the doctor. They have ran some tests and can't tell me for sure if it's lupus or not. The "viper" test was positive for lupus, but her ANA was negative. Her sed rate and c reactive protein levels are elevated. The specialist i took her too, recommended taking her off the birth control patch to see if the symptoms go away or continue. She has been off the patch for three weeks now, and the symptoms are progressively getting worse, not getting any better at all. This past weekend it actually took her 30 min to be able to move, her joints hurt to the point that she said it felt like her legs were "locked up". The flareups continue as well on a daily basis just about. So today, the specialist said that it may take 3 or 4 months to get the patch out of her system? I'm not sure, but i would think it being transdermal in nature it shouldn't take that long to be out of her system, and that the symptoms should lessen in degree of severity, not worsen. Any thoughts?

 
Old 01-10-2006, 03:42 PM   #2
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

Hello, I don't have answers for you but I will say I wish they would take the patch off the market. It is causing too much damage. I got DVT from it. Has she been checked for clots? I will be praying . God Bless, Diane

 
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Old 01-10-2006, 03:52 PM   #3
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

Thanks Diane for the reply. I am very glad she was taken off the patch myself. She was put on the patch for ovarian cysts, which luckily havent' reoccured so far. They have asked her about leg/calf pains (a sign of possible blood clot). Which luckily she doesn't complain of that or chest pains or the like. They have done lots of blood work on her, but say it all comes back negative, so they really don't think she has Lupus. But i keep focusing on the symptoms she is having....she meets the 4 out of 11 listed on this forum board. She has the malar rash, arthralgia, skin rash on both of her legs (which has been present for over a year now) and photosensitivity. She also complains of being cold alot. Also complains of burning and pain across her cheeks and nose when the flareups start. But the Rheumatologist is focusing on her ANA being negative....which i know can be negative and a person still have Lupus. This is so frustrating....but all thoughts and replies are appreciated.

 
Old 01-10-2006, 03:54 PM   #4
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

Dear Dark_eyed_angel,

There is a link above by which you can find info on Ortho Evra. Click the tab that says "Resources". Then click the link for "MedlinePlus". Then click the link for "Drug & Supplement & Herbal Information". Then go to the letter "O", then click the link for "Ortho Evra (systemic)".

I scanned the info briefly & did see plenty of side effects that may---or may not---be in the ballpark.

About the "viper test": Is this also known as the Russell viper venom test? If so, I *think* it's a screen for antiphospholipid syndrome, a clotting disorder seen mostly in people with lupus, but also seen occasionally in people without lupus.

There are multiple tests for antiphospholipid syndrome, I think, plus (I think) false positives on some are possible. Plus not all people who are positive on some of the tests require actual treatment. So I wouldn't be a good one to try to take this aspect any further. MAYBE SOMEONE HERE CAN AUGMENT &/OR CORRECT WHAT I'VE JUST WRITTEN.

Is this dr. a rheumatologist? If not, if your daughter & you are just too nervous about all this (and who could wonder at that?), maybe you could locate one nearby known to have a large lupus practice.

I hope others chip in with their thoughts soon. Meanwhile, best wishes to your daughter & to you. Sincerely, Vee (Dx'ed with Ro-lupus, positive for anti-Ro but always negative for ANA)

P.S. Where lupus is suspected, some drs. order straight off tests for various autoantibodies, complement levels, etc., as opposed to just ordering the ANA which is only a threshold test & is positive in other diseases, too. For more info, look at the 4 or so "sticky posts" at the top of the Board.

Last edited by VeeJ; 01-10-2006 at 03:59 PM. Reason: spelling

 
Old 01-10-2006, 06:28 PM   #5
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

Thanks Vee for the input. I checked out the link you guided me too. I am very much hoping that it is drug induced lupus and that by coming off the patch her symptoms will fade away. She had been on the patch for a year before these symptoms "flared-up", so i'm a little hesitant to believe that after all that time it finally caused all this. But i'm willing to give this rheumatologist the benefit of her knowledge and to wait and see what happens. I'm going to have to research the russell viper venom test in more depth. As well as antiphospholipid syndrome. Her C3 and C4 levels were slightly elevated with the blood work they done last month, as well as the sed rate and c reactive protein. To my knowledge...her antibodies are negative as well as the negative ANA. So much to learn about this stuff...alot to comprehend. But i do appreciate very much all the help and input you all have given me. I've read quite a few posts in different threads. And i can say i'm learning by leaps and bounds. Thanks so much!

 
Old 01-11-2006, 02:34 AM   #6
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

Dear Dary_eyed_angel, I have in my files an article that I found while searching for rash info. It's about DILE (drug-induced lupus) vs. SLE (systemic lupus). Here are some examples of the contrasts it cites between SLE and DILE---

4 of 11 crtieria: in SLE, 4 or more will exist; vs. in DILE, as few as 1, often only arthralgia.

In DILE, there would be no history of SLE-like symptoms before taking the suspected drug. The drug might have been taken anywhere from *3 weeks to 2 years* before symptoms appear. In DILE, after drug is ceased, clinical symptoms should improve, and ANA and other serologic markers should gradually decrease.

C3 and C4 levels *decrease* in SLE; in DILE, they remain normal. [You say your daughter's levels are slightly raised, not depressed. Has anyone suggested what might cause these to increase, even slightly?]

Antihistone antibodies are seen in 50% of SLE cases, but in > 95% of DILE.

Anti-ds-DNA is seen in 80% of SLE cases. In DILE, it's anti-ss-DNA that's seen, while anti-ds-DNA is rare (i.e., double-stranded vs. single-stranded).

Cutaneous problems are seen in > 75% of SLE and in only 25% of DILE; but in DILE, mucosal ulcers, hair loss, and discoid lesions don't occur, and photosensitivity has been correlated with only one particular type of drug. In DILE, the most common skin problems are purpura, erythema nodosum (painful nodules on extremities) and erythematous papules. Raynaud's is seen in 25% of DILE.

In both SLE and DILE skin rashes, immunufluorescence will show deposits of immunoglobulin G at the dermal/epidermal junction. [Since your daughter has rashes on her legs, has anyone suggested that a dermatologist or dermatopathologist perform a skin biopsy, incl. immunofluorescent testing?]

ANA is positive in both SLE and DILE in > 95% of cases.

Anemia is "almost always" seen in the course of SLE but is very rare in DILE.

Of the drugs listed as implicated in DILE (and only an *abbreviated* list was provided), there was a comment about a substance in certain "hormonal therapies" (whatever this is supposed to mean) called "leuprolide acetate".

For what the above is worth... In hers & your shoes, I think I'd probably consider trying to work through her skin issues with a dermie or dermatopathologist, an *additional* parallel approach that's possible where skin rashes (especially non-facial) are also present.

Re: labwork, your daughter could ask for photocopies to keep in her files, just in case she switches drs., etc.

A last thought: does your daughter take (or has she taken in past several years) any OTHER medication?

All best wishes to you both! I hope she & her doctors keep pressing for answers. Regards, Vee

 
Old 01-11-2006, 02:51 PM   #7
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Re: Has anyone heard of the ortho evra patch causing lupus like symptoms?

ANY estrogen related birth control sends my lupus into a tailspin...I was told not to ever use the stuff again. Except Depo-Provera. Thats because it's not estrogen. Hope this helps. Take care.

 
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