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    Suggest ways to rule out lupus

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Posted on Wed, 12 Jul 2017 in Lupus
Question: Hello Doctor,
I wrote to you in the past regarding some concerns with possible lupus. I went to a follow up with my primary back in April, and I was told that it was not lupus and that my symptoms seemed unrelated. So, when I asked for ANA test (as you recommended), she told me it wasn't necessary. She told me my joint pain was possibly due to low vitamin D and that my low white blood cell count did not mean lupus. So, I left it at that. The swelling and joint pain continued on and off. I continued to take vitamin D and kept taking the usual herbs that I had been taking before (for the joint pain).
I haven't been to see my doctor since then. I have been to the eye doctor several times though. My dry eyes are getting out of control, and I recently developed some type of nodule in one of my eyes surrounded by redness and burning that covers the entire white part of my eye. The eye doctor asked me if I had RA or Lupus and I said "no" but that I had a few symptoms before. After completing an eye exam, he told me I had inflammation that may be due to the dryness I suffer. My joint pain is coming back (as it comes and goes). My eyebrows and eye lashes are thinning, and I have become more sensitive to the sun. I live in a warm, XXXXXXX place, and I feel I am used to the weather. However, this past week, I was out on a warm day (not too hot) and my face became extremely red (almost a purple hue) and I felt feverish. The eye with the nodule was extremely red and affected. I have been a healthy person all of my life. I try to eat as healthy as possible, and I exercise regularly. Thus, all of these symptoms are causing concern; they are new and very noticeable. I honestly feel as if my symptoms were not taken seriously by my primary doctor, and I just wanted to get more guidance and clarity from you. I would also like to mention that 3 of my maternal aunts suffer and have suffered from RA (one past away already).Through blood tests and X-rays, RA was eliminated as the cause for my joint swelling and pain. I am wondering If I do have lupus? And if my symptoms are enough to be labeled as such? I know I probably need to go see my primary again, but I would really appreciate your opinion based on the symptoms I have described.
Thank you very much!
xxxxxxxxxxxx
doctor
Answered by Dr. Divya Agarwal 25 minutes later
Brief Answer:
Possibility of lupus/sjogrens/undifferentiated connective tissue disease

Detailed Answer:
hi
I agree your symptoms warrant at least an ANA test and tests for inflammation like ESR and CRP.
also an ENA if the ANA test is positive.
sometimes the disease may not present with all the symptoms associated with the disease.the disease may remain undifferentiated which means that a positive ANA is associated with symptoms like photosensitivity, dry eyes , Raynaud's, fatigue,and arthritis.
so I feel you should go ahead with the test.
I hope this was helpful.
regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Divya Agarwal 5 hours later
Is a ESR of 18 within a normal range?
doctor
Answered by Dr. Divya Agarwal 7 hours later
Brief Answer:
Yes

Detailed Answer:
it is normal
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 616 Questions

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