Re: Butterfly rash questions and my symptoms.
Sandpuff, To me it makes sense for you to see a rheumatolgist. A good rheumie should take a lifetime medical history. Have you seen the "4 of 11" criteria used to Dx systemic lupus? They are in one of the "sticky posts" (permanent info posts) at the top of the thread list. You do not have to meet the criteria all at once: think instead of checking each off in indelible ink. So that's why taking a LIFETIME history is critical.
Blood tests can vary in lupus, I've read & been told, because some values will wax & wane with flares. Also, some labs are better than others at running these tests, which is another reason to see a specialist (i.e., who'd be using the best labs for this branch of medicine).
Yet another reason to see a rheumie: I found my local drs. didn't understand just how varied lupus can be. I finally went to a teaching hospital rheumie, who suspected immediately that I had the SCLE (subacute cutaneous LE) variant, which further testing confirmed. In it, only 70% or so are ANA-positive. I stayed ANA-negative (my luck!), which really frustrated Dx. This is possible in SCLE. More likely yet in DLE (discoid lupus). Rare, but not impossible, in classic SLE. [So I was told.] Bottom line? ANA alone is NOT diagnostic of lupus & was never intended to be. That's why there are 11 criteria, not one.
Many rheumies run the specialized autoantibody *simultaneously* with ANA, as opposed to waiting for a positive ANA before ordering tests for specific antibodies (e.g., anti-ds-DNA, anti-ss-DNA, anti-Sm, anti-Ro, anti-La, RF, etc.)
There are several excellent lupus hardcovers in most libraries & bookstores. One author is Dr. Daniel Wallace; another is Dr. Robert Lahita. While reading won't get you a Dx, it can help you ask better questions.
While I hope you don't have lupus, if you DO, you could benefit so much by knowing & being treated. FYI, many people do remain pretty mild. So hang in there, OK?! I hope you keep posting & that you have a good appt. Best wishes, from Vee