Brief Answer:
Autoimmune disease

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your CT report attached previously.. I would say it does look like a confusing report as they have mentioned 3 pathology of the lung in 1 report which is a bit unlikely... If you could attach the films it would be helpful.

The consolidation and Tree in bud appearance does point towards Autoimmune disease , as these can appear in a disease called Interstial lung disease...Which is mostly an autoimmune disease due to high ANA...But the nodules mentioned doesnt explain in it.. Although some of the nodules can come in ILD as well, it is something we need to keep a watch on...

I would like to know a few more symptoms to know if it is affecting any of your symptoms:

1. DO you experience oral ulcers/hair fall/rashes over the body

2. Any history of dry eyes or dry mouth

3. Any history of skin color changes or skin tightning?

4. Any difficulty in climbing stairs??

SCL 70 does indicate a disease called scleroderma which can explain the lung findings...But do let me know these queries...As we need to co relate your symptoms with the antibody positivity as well

REgards
DR Naval

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Brief Answer:
Autoimmune disease

Detailed Answer:
good evening

Well your symptoms do point towards an autoimmune disease, more of Sjogrens syndrome than lupus. dry eyes dry mouth and lung findings.

You can get the pet scan done, I am not sure how useful it will be as it will highlight the nodules again. The only test I would like. to do is a biopsy from one of the nodules. As biopsy is gold standard and will help us in ruling out cancer.

But my diagnosis still favors autoimmune disease like sjogrens. It is a very slow progressive disease and that may be one reason you don't have symptoms despite so many lung findings. it can even take 4 to 5 years before throwing symptoms.

More blood work will involve just looking at other organs to see if any other involvement is there or not. I am sure it must have been already performed.

But do see a rheumatologist. he can help you sort it out better

Hope the information was useful

do let me know for more queries

regards
dr naval

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Brief Answer:
Sjogrens Syndrome

Detailed Answer:
Good evening

Well, any reason they found out why Iron and Vitamin D were not getting absorbed from the bowel or was it just a routine finding???Females do have low iron and Vitamin D is defiecient in 90 % of the world population.

As for Sjogrens syndrome, it is a slow disease and takes lot of time to develop. It can go slowly for 10 years before throwing symptoms. You may have simple symptoms like Dry eyes or dry mouth along with fatigue but nothing more. Lung problems are common in it, but initially patients dont have much symptoms.
It is controllable problem, not curable though....

Do consult a rheumatologist about this disease and your ANA profile. You can let me know the PET CT report as well..

hope the information was useful

regards
Dr naval

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Brief Answer:
Is it scleroderma

Detailed Answer:
Good evening

Well, the antibody for scleroderma is positive, but the CT findings dont point towards Interstitial lung disease( ILD). They have pointed more towards nodules and consolidation which doesnt fit in for ILD. Plus you dont have any skin symptoms like tightening and pigmentation or reflux.. SO just on the antibody positivity , we wont call is Scleroderma, but definitely would like to observe. I still feel we should get your CT re reported...Moreover you are going for the PET SCAN, so that will give us a clear picture if it is ILD or something else

Do let me know for more queries

REgards
Dr Naval

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Brief Answer:
Further Course

Detailed Answer:
Good evening

Well, yes I had my doubts about the reporting as well as Granulomatous is more of a pathology finding than radiological. So I had suggested if someone can re report it as Doctors are not right all the time...

With your blood work, it does look like Autoimmune. ANA positive and few other antibodies positive indicating the same. Lupus/sjogrens/Scleroderma all belong to the same family.

It may not be lupus as lung involvement comes very late in it and patients do experience symptoms. Early lung involvement is either Sjogrens or scleroderma. But the CT reporting doesnt look very convincing...So I was relying on PET..Or else if some other radiologist can re-report it. A biopsy will be needed to rule out cancer..But we just need to confirm our findings first...

Do let me know for more queries

Regards
Dr naval

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