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Old 01-09-2012, 08:55 AM   #1
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Lupus? RA? Something else????

Hi Everyone,

While I know no one can tell me for sure, im just wondering what peopleís opinions are on my symptoms etc.

Since may I have had rotating joint pain, not usually any inflammation, sometimes some redness... never the same joints on each side... the pain usually lasts for about 3-5 days, then disappears, sometimes coming back in another joint, or just leaving all together. I have had chest pains/elevated heart rate during my second pregnancy, which warranted a battery of heart and clot tests mostly came back fine, other then a valve which pumps a bit slow. During my first pregnancy, I had boarder line pre-eclempsia, (protein in the urine and high blood pressure (I realize these could be un-related).

I have asthma; I have pretty bad allergies, which have been expanding this year to different fruits, vegetables, and nuts. I get rashes on my forearms, and around my trunk (could just be dry skin). I have also had a random red rash on one cheek with little white bumps in it that disappeared after three days. I have very light sensitive eyes. I get a couple ocular migraines a year (when I lose peripheral vision in one eye, and get floaters). I also get frequent headaches, and I get dizzy and light headed for no reason at all. I get white/blue fingers periodically. Iím usually very tired, despite having a full night sleep, and lately I blank out on my train of thought mid conversation!

I have been referred to a rheumy, just waiting for the call.

They ran some blood work, and this is what I was told (I donít understand it thought)
ESR - negative
RF factor - 88
CRP - 27

They have re-run the blood work and added ANA to it, so I am waiting on those results as well.

Currently I am on naproxen, but it barley dose anything for the pain... sigh.

Any thoughts appreciated.

 
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Old 01-11-2012, 05:58 AM   #2
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Re: Lupus? RA? Something else????

Bella, hi & welcome. In your lab printout, can you tell the "reference range" for RF ? That's probably Rheumatoid Factor, which can elevate in lupus, in RA, and maybe some other inflammatory diseases, too (not sure, sorry).

In same vein, I think CRP is C-reactive protein, which can elevate in lupus & RA & maybe some other things, too.

Have you seen the ACR (American College of Rheumatology) criteria for systemic lupus (SLE)? You'll find them in the "sticky posts" (permanent info posts) at the top of the thread list. Generally you have to meet 4 or more criteria, not necessarily all at once--- to be diagnosed with *systemic* lupus. (A lesser form called cutaneous lupus also exists & for that you don't have to meet 4 or more.)

In same vein, RA has its own ACR criteria, which I don't know off the top of my head.

Hope this gives you more to think about prior to your rheumatology appt. BTW, I took Naproxen for years, for periodic cramps---and it didn't do much to touch my lupus symptoms, for what that's worth. Hope you keep posting here. Sending warm wishes, Vee

 
Old 01-11-2012, 06:32 AM   #3
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Re: Lupus? RA? Something else????

Hi Vee,

Thanks for your replys, I have read through the crieteria, and they sound like I can meet 4 or more, then again, maybe not, lol... it is hard to say.

I do not know the range for my RF, or CRP, you are right for what they are... I never recieved a print out, i just asked what the numbers are and that is what she told me.

From what I have found on google, a normal RF is less then 40 u/ml, and mine is 88. and for crp, normal is less then 10u/ml.

I currently dont meet the criteria for RA, but im afraid that that is what I will get diagnosed with, becuase for some reason that seems to be what is a more common first diagnosis (based on previous posts I have read all over).

Currently, for the past 5-6 days, I have had terrible shoulder/neck pain, the muscles in my upper back are very inflamed, and i feel like I am pinching nervs in my neck.

*sigh* hopefully my apointment will not be too far off in the future!

 
Old 01-11-2012, 06:59 AM   #4
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Re: Lupus? RA? Something else????

Malar Rash - no
Discoid Rash - no (but i get another rash on my forearms)
Photosensitivity - not that I know of...
Oral Ulsers - when I eat something im alergic to
Arthritis - yes
Serositis (pleuritis or pericarditis) - yes
Renal Disorder (persistent Proteinuria in the urine or cellular casts) - have had protine, blood, and white blood cells in the urine.
Neurological disorder (seizures or psychosis) - no
Hematologic disorder (anemia, Leukopenia or lymphopenia on two or more occasions,thrombocytopenia - no
Immunologic disorder (positive LE cell preparation, abnormal anti-DNA or ANTI-Sm values, False postive VDRL (syphilis test) - not yet tested
Abnormal ANA Titre - dont know my results yet.

 
Old 01-12-2012, 01:35 AM   #5
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Re: Lupus? RA? Something else????

Bella, as you said, it's hard to know how your rheumatologist will count your criteria---but from your tally, it does seem to me that you're booking booked to see the right kind of specialist! When you go to your appt., you could ask what he/she has counted. (My best drs. commented freely on how many I'd met, without my asking.) Here's how I understand certain aspects of those criteria:

I was told that once a systemic criterion is met, it becomes YES permanently. Envision checking it off in INDELIBLE ink.

Another source of confusion is, how to apply the discoid & malar rash criteria for a patient who has neither, but instead has some OTHER lupus-specific rash? I believe the OTHER lupus rashes---subacute cutaneous, tumid, etc.---are kinda/sorta counted as "discoid". (At point of Dx, I'd had SCLE targetlike rashes for years, but never a malar or discoid. I asked why only malar & discoid are listed & was told that it wouldn't be helpful to include the less common lupus rashes on the liist---wouldn't help "trap" many patients.)

What does your forearm rash look & feel like? Does it scar or depigment? Is it UV-induced? (Only curious.)

Re: protein, blood & WBC in urine, did you have a UTI at the time? I think this criteria is intended to count kidney filtering problems when there ISN'T a UTI causing the abnormal test results.

Another factoid from left field: some people met criteria for both RA and lupus, in a "crossover" syndrome called "rhupus".

Anyhow... you've clearly done your homework & should be able to understand what your new specialist says & does. I appreciate your being a little scared, but if this IS lupus, RA, or some combo of the two, you'll benefit from having it diagnosed and treated. Keep us posted, OK? More best wishes, Vee

 
Old 01-12-2012, 06:52 AM   #6
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Re: Lupus? RA? Something else????

Quote:
Originally Posted by VeeJ View Post
Bella, as you said, it's hard to know how your rheumatologist will count your criteria---but from your tally, it does seem to me that you're booking booked to see the right kind of specialist! When you go to your appt., you could ask what he/she has counted. (My best drs. commented freely on how many I'd met, without my asking.) Here's how I understand certain aspects of those criteria:

I was told that once a systemic criterion is met, it becomes YES permanently. Envision checking it off in INDELIBLE ink.

Another source of confusion is, how to apply the discoid & malar rash criteria for a patient who has neither, but instead has some OTHER lupus-specific rash? I believe the OTHER lupus rashes---subacute cutaneous, tumid, etc.---are kinda/sorta counted as "discoid". (At point of Dx, I'd had SCLE targetlike rashes for years, but never a malar or discoid. I asked why only malar & discoid are listed & was told that it wouldn't be helpful to include the less common lupus rashes on the liist---wouldn't help "trap" many patients.)

What does your forearm rash look & feel like? Does it scar or depigment? Is it UV-induced? (Only curious.)

Re: protein, blood & WBC in urine, did you have a UTI at the time? I think this criteria is intended to count kidney filtering problems when there ISN'T a UTI causing the abnormal test results.

Another factoid from left field: some people met criteria for both RA and lupus, in a "crossover" syndrome called "rhupus".

Anyhow... you've clearly done your homework & should be able to understand what your new specialist says & does. I appreciate your being a little scared, but if this IS lupus, RA, or some combo of the two, you'll benefit from having it diagnosed and treated. Keep us posted, OK? More best wishes, Vee
Vee,

Thanks again for your wonderful comments.

My rash does not scar, it looks like scaly red patches on my forearms. I am not sure if it is sun/uv induced, something I have not payed attention to yet, but im sure I will start!!

I had protien in my urine during my first and second pregancy (higher in my first). And I also had a Kidney infection not long after my second child, I found out because i went to the hospital with constant vomiting (Ive never had a UTI), where they told me that I had a kidney infection, and I sat for 6 hours with a saline drip and IV antibiotics!

My Appointment has been set for March 13th, so until then, I will continue to keep track of any pains, and anything else strange that is going on with my body. At the time of my apointment, my journal will be 2 months shy of a year...

 
Old 01-16-2012, 06:19 AM   #7
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Re: Lupus? RA? Something else????

I asked for a copy of my blood work,

I have my reference ranges:
CRP < 10.0 mg/L (I have 27.0 H)
RF < 20 KIL/L (I have 88 H)

 
Old 01-16-2012, 06:59 AM   #8
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Re: Lupus? RA? Something else????

Eek, those are high! My best advice is, while you're waiting for your March appt., keep reading. You'll understand what aspects of your history could be the most germane, hear the rheumatologist better, and maybe develop additional questions. Keep in touch, OK? Sending my best, Vee

 
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