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Have POTS, joint pain, swollen lymph node in neck, weight loss. Should I be worried for lupus?

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Hi- the doctor told me last night that I have SLE> which I have symptoms that follow - ache and pains (flu like symptoms) joints ache on occasion (wrist, back , hips) feel just plain flu-ish fatigue swollen glands and a swollen lymphnode in my neck, BUT I also have ALOT of weight loss, and malabsorbption , Also have P.O.T.S (postural orthostatic tachy syndrome)

I had an XXXXXXX 1:160 speckeled - but the rest of the labs don't make sense

Neutrophil cytoplasmic AB IgG was <1:20

my SSA (ro) )ENA AB igG was 8 then it has a f up high with a 1

my SSB (La) (ENA) AB, IgG was 0

my Ribonucleic Protein (ENA), IgG was 0
XXXXXXX (ENA) AB igG was 0

Scleroderma (SCL-70) ENA AB was 3

now according to the lab results it states the in order for the SSA or the SCL-70 to be positive it has to be more than 29.

Also the SSA (ro) ENA says if that's high its seen in Sjogren syndrome,SLE, and progressive systemic sclerosis.

and the SLE-70 (ENA) says scleroderma antibody is seen in patients with scleroderma and is considered diagnostic and specific to scleroderma if it is the only ENA antibody present.

next sentence SLE-70 is also seen in approximately 25% of progressive systemic sclerosis

so even if my titers were High wouldn't I have progressive systemic Sclerosis not Lupus? why is she saying Lupus.... personally I XXXXXXX not want to have Progressive Sclerederma but it seems here quite possible...

I need help the doc wont call me back.......
Posted Wed, 8 May 2013 in Lupus
Answered by Dr. Raju A.T 8 hours later

Thanks for your query.

Yes, you are right in your interpretation.

The SSA (Ro) (ENA) Antibody, IgG and Scleroderma (Scl-70) (ENA) Antibody, IgG should be more than 29 to consider for further specific evaluation or around 40 to confirm the diagnosis.

Both the above specific autoantibody tests are not conclusive hence the diagnosis of SLE is considered.

It’s a rule that if no specificity in the autoantibodies is established by tests, the diagnosis is considered to be SLE. This is based on the fact that the XXXXXXX incidence is greater than 90 percent in juvenile idiopathic arthritis.

Also it is important and essential to consider the clinical findings along with the laboratory parameters to arrive at a diagnosis. I believe this is how your treating doctor considered the diagnosis of SLE in you.

Hope I answered your query.

Please let me know if there are any other concerns.

Above answer was peer-reviewed by
Follow-up: Have POTS, joint pain, swollen lymph node in neck, weight loss. Should I be worried for lupus? 10 minutes later
Couple of questions - can an XXXXXXX - show lymphoma?
I have fat malabsorbtion and they don't know why..... its really scary, also I have 2 swollen nodes in my neck the one on the left is 1cm very movable doesn't hurt the other is about 1 cm WAY under my jaw. they have been bothering me

the only connection to fat malabsorbtion to me is lymphoma.... I had a colonoscopy they found nothing I had an EGD showed gastritis , I had a HIDA scan normal RUQ ultra sound NOrmal CT abdomen pelvis normal , spleen also normal.
I have lost 24 lbs since November....
so......can an XXXXXXX represent lymphoma instead?
I get low grade temps....

can a CT of sinus show lymphoma?

I started to have fat malabsorption 2 weeks after I lost my baby-- there I was given a whole bunch of antibiotics when Ididnt have an infection..... maybe that's why I have fat malabsorption

scared for lymphoma and scared for sclerederma- please let me know what you think
Answered by Dr. Raju A.T 11 minutes later

Thanks for writing back.

As I mentioned in my previous post, Scleroderma could not be considered as a possible diagnosis with Scl70 being negative.

Yes, there are chances where the XXXXXXX positive could be secondary to lymphoma. Since there are no intra-abdominal lymph-nodes or any other lymphoid organ changes those expected in Lymphoma, the diagnosis of lymphoma can be considered after further evaluation like FNAC of the swollen lymph nodes.

FNAC is an invasive test where in a small amount of material is extracted from the affected lymph node by a needle and subjected to microscopic examination. This is best modality in diagnosing the Lymphoma.

Yes, the fat malabsorption could be secondary to consumption of heavy doses of antibiotics. This may be reversible.

Do discuss about the same with your treating doctor and proceed further.

Wish you good health.
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