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How To Rule Out Lupus?

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Posted on Tue, 24 Nov 2015
Question: For months I have experinced extreme fatigue, lack of abilty to concentrate, generalized pain and weakness (especially my back), recurring mouth sores and metallic taste in mouth, daily headaches, poor circulation (always cold and anytime I drink a cold drink my fingers and toes turn white and numb), eyes BURN several times a day, low grade fevers, plus my face has often been looking "sunburned", oh and some occasional nausea...I FINALLY went to the doctor and she suspected an auto immune diesase (she specifically mentioned lupus). She ran a lot of blood work and the nurse called and said labs were normal but she is still referring me to an endocinologist for further evaluation. Today my facial rash is the worst it has ever been...I looked at pictures of lupus rash on the internet and it looks the same except mine face is also swollen today...I did not go back to the doc (cant afford it if I have to save to see an endocrinologist) but they called in oral steroids for me. From what I read if it is lupus, my labs should show something. And, if that's what she suspects it look like normally one would go to a rheumatologist (not an endocrinologist) Can anyone address if a lupus rash can involve swelling? And shouldn't lupus be ruled out based on initial labs? Please offer your thoughts on diagnosing lupus or a differential diagnosis that would send me to an endocrinologist...thanks! PS - I attached a pic of my rash today...i look horrible but that's what I feel like:(
doctor
Answered by Dr. Dr. Shruti Rijhwani (24 minutes later)
Brief Answer:
Yes to me it sounds like classical Lupus.

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well looking into your query , I will like to tell you that your features and rash looks classical of SLE . In my opinion you should immediately be evaluated for Lupus . In lupus also malar rash can lead to swelling of face plus since you are taking steroids it may also lead to swelling . Can I see your lab results so that I can advise which more tests need to be done . Meanwhile just avoid sun exposure and use sunscreen with SPF > 50 even when staying indoors .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Shruti Rijhwani (28 minutes later)
Yes i can send them once I get them (just got a phone call today that said they were normal but no copy yet)...the doctor mentioned that she was going to run a "rheumatoid panel" which I thought would rule out lupus if it came back normal...that's why I am confused about the need for further evaluaton from an endocrinologist
doctor
Answered by Dr. Dr. Shruti Rijhwani (26 minutes later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

For Lupus specific antibody testing needs to be performed , which I will guide you after seeing tests . I dont think there is need for endocrinology consultation but considering that your doctor is suggesting same there must be some reason or abnormality in your tests which has shown up which has prompted him to ask for endocrinology consultation .That I can comment only after seeing reports.

Dr. Shruti
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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How To Rule Out Lupus?

Brief Answer: Yes to me it sounds like classical Lupus. Detailed Answer: Dear Madam, Thank you for posting your query on HCM. Well looking into your query , I will like to tell you that your features and rash looks classical of SLE . In my opinion you should immediately be evaluated for Lupus . In lupus also malar rash can lead to swelling of face plus since you are taking steroids it may also lead to swelling . Can I see your lab results so that I can advise which more tests need to be done . Meanwhile just avoid sun exposure and use sunscreen with SPF > 50 even when staying indoors . Dr. Shruti