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JAM1001 10-10-2012 06:36 PM

Hi...I am new to this forum and have some questions that I am hoping someone can answer.

I have been referred to a rheumatologist by my GP because of progressing pain in my knees and elbows. My blood work shows elevated levels of CRP and ESR as well as a positive ANA screen with a Homogenous pattern. I tested negative for the rheumatoid factor and she said I need to have a lupus evaluation? The other thing is that my white blood cell count has been consistently moderately high for the past several months so she wants me to see a hematologist too. Infection has been ruled out. I'm just not sure what all of this means and what I should expect when I see the rheumatologist. I should note that I had ITP as a teenager and as a result of that, I had my spleen removed.

Thanks for your help.

ladybud 10-11-2012 01:03 AM

Re: Nervous...
The rheumatologist will want to review your history, current symptoms and probably order more blood tests. The sed rate and CRP elevation indicates inflammation, which is most likely causing your joint pains. The ANA is a screening test for lupus, an autoimmune disease, and it sometimes occurs in people with ITP or a history of it. The elevated WBC may be from the inflammation. Lupus can actually cause high or low WBC counts, so that is not unusual. A diagnosis of lupus is based on lab results PLUS certain symptoms. You can read more about that on the sticky notes at the top of the lupus board. The Dr. will most likely start you on treatment for it if a diagnosis can be made at this point. If not, you will need to be monitored and treated symptomatically with antiinflammatories. Having had your spleen removed puts you at somewhat higher risk for infection, so try to reduce your exposure to anyone you know has an infection you could catch. Hope this helps until you get to see the rheum.

JAM1001 10-11-2012 10:14 AM

Re: Nervous...
Thanks so much. I don't know very much about Lupus - I just know that i'm in a lot of pain and hope to figure out why. I can't even get up and down off of the floor by myself and going up and down the stairs has even become difficult. I'm only 43 and suddenly over the last few months I'm exhausted and in pain all of the time. I know I am more susceptiple to infections and that is why we ruled that out first. My doctor has also basically scared the crap out of me with the possibility of a "low grade lymphoma." I honestly don't have any symptoms for that though other than itching and the elevated WBC.

ladybud 10-11-2012 12:20 PM

Re: Nervous...
Lupus can cause itching too because histamines are released as part of the inflammatory process. Some people even get hives with it. An antihistamine may help with the itching. Both fexophenadine and loratidine are OTC and non-drowsy formulas. I hope your rheum appt goes well for you.

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