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Dr. Andrew Rynne

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Are mouth ulcers, numbness in the hands, migraine and hair loss symptoms of lupus?

Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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Posted on Mon, 29 Aug 2016 in Lupus
Question: I had a positive ANA 1:40 with Nucleolar pattern and an anti DS DNA 6 (intermediate) come back. I have mouth ulcers, numbness in hands feet and legs, extremely tired, migraines, muscle spasms, hair loss, the list goes on. How likely is it I have Lupus? My mother has MS.
doctor
Answered by Dr. Naval Mendiratta 47 minutes later
Brief Answer:
Is it lupis

Detailed Answer:
good evening

thank you for writing on health care magic

Well the diagnosis of lupus is usually based on clinical symptoms and the blood tests..

As per your clinical symptoms of oral ulcers, hair loss, fatigue ,Myalgias it does favor some autoimmune phenomenon is going on...

But as per the blood results the titres of ANA are still not high enough to diagnose it as lupus. I would like to know a few more details

1.What about your other blood test like Complete blood count, ESR and urine routine.

2. secondly was only dsdna carried out or did they do complete ENA profile..

3. how bad are your oral ulcers.. are they painful also? any genital ulcers

4. any history of joint pains or swellings..

5. any rashes anywhere in the body which get worse on sun exposure

if you could attach the test results it would be helpful

await your reply

regards
drnaval


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Naval Mendiratta 21 minutes later
Complete ANA and a separate lab did the anti DS DNA. My potassium was 2.8 I'm always low on potassium. All other labs normal. I know nothing of an ENA? Also, mouth sores came when it flared up a few weeks ago and are now gone. No gentile sores. Feet and hands swell. Joint pain yes. Mainly increasing memory loss, trouble speaking at times...heat really bothers me. I also have had a rash on my hands that lasted 2 days in between and on fingers. I have a foot ulcer that has been there 8 months..my doctor has no clue what it is. It's painful and isn't healing. Why does it specifically say positive ANA in my labs if 1:40 isn't considered positive?
doctor
Answered by Dr. Naval Mendiratta 18 hours later
Brief Answer:
Is it lupus

Detailed Answer:
good evening

sorry for the late reply... had a long duty on Sunday as well

As per your queries :

1. ENA profile is a further study of ANA. it checks all the antibodies associated with lupus or any other connective tissue disease for that matter. it does gives us a clue on which organs which should be looking at and moreover confirms the diagnosis of lupus. alone anti dsdna is never specific in making the diagnosis of lupus as it can be negative in 30 % patients.

2. Your symptoms do favor lupus. oral ulcers rashes joint pains myalgias... and ana positive.. But if other reports of kidney and liver are normal, I would call it as a minor organ one... But yes, would like to review all the reports

3. As for the ulcer which is non healing. it can be due to vessel inflammation (vasculitis). if you could attach a picture it would be helpful. Moreover a non healing ulcer you should get a biopsy done from the site to know what exactly it is. The treatment will depend on the results.

4. as for the ana positive, It has many titres. 1:40 can be false positive as well... or at times it happens the disease has just begun. We normally take a cut off 1:160 to confirm it is specific. But never the less, if these symptoms are coming we still need to treat you.

Do let me know for the results and if you could attach the ulcer picture as well..

regards
Dr naval
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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