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Suffering for skin rashes, vertigo, asthma and joint pain. Positive results for SLE. What could be this?

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
I have a positive XXXXXXX with 1:640 Nucleolar Pattern, Positive SL70 , Thyroglobulin 187 and Thyro8id Peroxidase of 1933 . What could this be . I have alot of pain.
Posted Mon, 20 Aug 2012 in Asthma and Allergy
Answered by Dr. Shanthi.E 3 hours later

Thanks for posting your query.
XXXXXXX is a good screening test for SLE). It is positive in 95% of patients with SLE. Positive SL70 is also seen in SLE.

Raised titers of Thyroglobulin and Thyroid peroxidase suggest autoimmune response within the thyroid gland.

Overall, there is an autoimmune process occurring in your body.

All the four tests are non-specific. They are elevated in many autoimmune conditions.

Could you please tell me a bit more about your relevant symptoms? In addition, I would like to know about all the blood tests reports that you have apart from the ones you mentioned in the query.

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

I would like to give a more personalized answer to you.

Awaiting your response.

Above answer was peer-reviewed by
Follow-up: Suffering for skin rashes, vertigo, asthma and joint pain. Positive results for SLE. What could be this? 18 hours later
I don't have a scanner , so I cant upload ...but I can tell you that I have an IgM of 53, scleroderma antibody at 120, ast 39 and ALT of 46 . I have had squamous cell Ca of the skin, rashes . I just had a biopsy and will let you know the results tomorrow. I have vertigo episodes, extreme sicca symptoms , mild neuropathy in lower extremities . Just Dx with lymphedema in legs. I have asthma, sleep apnea, chronic pain in joints. I am taking Plaquenil , for 26 years now . I also take lisinopril for HTN ,Zoloft for depression, HTCZ 25 mg HTN , Singulair for allergies, Nexium for GERD , Advair for asthma , Restasis for dry eyes and Ultracet for pain, Evoxac prn for extreme dryness. My CBC and CMP are normal , except the alkaline Phosphatase is 149, st 47 , alt 95. I have mild raynauds, severe Heberden's and Bouchard's nodes. Negative on CCP,and RF ,CRP and sed rate were normal. neg double stranded DNA , XXXXXXX RNP , SSA, SSB , and neg anticardiolipin antibody. Previous XXXXXXX was 1:1280 in nucleolar pattern, scleroderma antibody of 120 . Also the complement levels were normal . I also have SOB and chest pain often . Cardiac tests normal. I hope this helps ! Thanks so much . You're a pretty doctor !
Answered by Dr. Shanthi.E 2 hours later

Thanks for giving me all the relevant details. Let us exclude the possibilities one by one. It is fine that you could not upload the reports; you have given in depth information now.

Plaquenil is a DMARD drug used in the treatment of Rheumatoid Arthritis (RA). You are taking it for 26 years now. Anti-CCP is a specific marker for RA, you are negative for it.

One reason for a negative Anti-CCP can be due to prolonged use of Plaquenil which has neutralized the antibody. RF is usually negative in patients with RA.

I understand that you are experiencing extreme sicca symptoms with dry eyes. Restasis and Evoxac are both effective in controlling the dry eye symptoms. Please continue to use them on as and when required basis.

The ALT, AST, alkaline phosphatase levels are just above the normal range. For them to be significant, the values must be at least 3 times the normal.

Raynaud's phenomenon is a characteristic manifestation of Scleroderma, more so in the limited cutaneous form of Systemic sclerosis (lcSSc).

Severe Heberden's and Bouchard's nodes are characteristic of OA or Degenerative arthritis.

It is good that CRP and ESR are normal. It means to say that the disease activity is minimal.

Negative anti-double stranded DNA, anti-smith antibody, anti-RNP rule out SLE in you.

Though anti-SSA and anti-SSB are negative, there is still a strong possibility of lcSSc in you, owing to your symptoms.

A nucleolar pattern of XXXXXXX is more common in systemic form of Scleroderma.

Scleroderma does affect the lungs causing pulmonary fibrosis. It also affects the heart. This could be the reason for shortness of breath and chest pain in you.

It is very important to get your lungs tested every 6 months to look for early fibrotic changes.

Limit your daily intake of Vitamin C to less than 1000mg as stimulates collagen formation and its subsequent deposition.

You are on the right medications, please continue to take them. Cyclophosphamide has been shown to be effective in Scleroderma in recent studies. Please discuss with your treating doctor about this.

Maintain your core body temperature in normal range and wear warm clothes to prevent repeated episodes of Raynaud’s.

Please write back if you need clarifications and also do let me know about the biopsy report.

You are doing fairly well.

I wish you good health.

Above answer was peer-reviewed by
Follow-up: Suffering for skin rashes, vertigo, asthma and joint pain. Positive results for SLE. What could be this? 16 hours later
Thanks so much Dr. Shanthi. You're information has been very enlightning. My biopsy showed a contact dermatitis .... so now I must figure out what Im allergic to. I will talk to my Dr about the cyclophoshamide. God Bless, XXXXXXX
Answered by Dr. Shanthi.E 27 minutes later

Thanks for writing again.

Contact dermatitis can be cured easily. The main action would be to avoid the allergen that causes it as you said.

I hope the information has been helpful to you.

I wish you good health.

You may please close the discussion and write a review for me.

Thanks and take care.

Above answer was peer-reviewed by
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