Question: I am a 33-year-old Caucasian married mother of a 2 1/2 year-old.. When baby was three months old, I fell down a long flight of stairs going for diapers in the middle of the night. If you weeks later I developed a bad cold/flu. Right after that I started having tooling in my hands and arms and legs and feet and also dry eyes. I went to an orthopedist in a neurologist. Orthopedist ruled out major injury and suggested physical therapy, which I did. Neurologist's blood work up revealed elevated ANA of 640 and he said that was suspicious for lupus and referred me to a rheumatologist. Metallic just work up showed ANA was still elevated at 160 and was unsure if the symptoms were related to onset of lupus or the back injury.

I have since gone to several rheumatologist who have given me conflicting projections. Some minimize the likelihood of my developing lupus, even though I am in the childbearing range in which lupus typically develops. Others say it is a strong possibility and end with "but if you do develop lupus we have medications to treat." One rheumatologist recommended going on plaquinil now and staying on for two years and "seeing how I do". Others say my risk for developing lupus is minimal since the ANA is reduced. Other than occasional dry eyes, for which they have ruled out Sjogren's at this time I have no other lupus symptoms at this time . Others say "once 640, the possibility of that and it's associated disease risk returning continues."

Needless to say, with a small child I certainly would like to dodge this bullet if possible. The professionals all seem to agree that there is a hormonally related factor in lupus, hence that it attacks mostly childbearing age women, but don't seem to see pregnancy as a trigger for the onset in people who are not yet symptomatic. I do not have a Lupus diagnosis and don't have, at this time, any of the real lupus symptoms. Believe me I become very well-versed in then and am on the alert.

My question is this: my husband and I would both like to have a second child, but neither one of us wants to take the risk of my developing a debilitating disease and not being able to take care of either child. Do you see pregnancy as a possible trigger for bringing on lupus in those who have a positive ANA but no other symptoms?

Unfortunately my husband and I are traveling and I cannot access my blood results file. I am very certain it is anticoagulant. I have had a complete endocrinology work up. They detected three nodules which they were watching. Two of the nodules disappeared during this past year and another one appeared, none of which are considered problematic. At one point my XXXXXXX ride was considered minimally low and I was prescribed the lowest dosage of levothyroxine. Most recently it has been discontinued. My endocrinologist said if I am planning a pregnancy he would put me on it again.

Despite the fact that my ANA has gone down to 160, I have been told that "once 640 always 640" and that the risk of lupus remains high and that the ANA number remaining positive is what matters. My concern for developing lupus is both for myself and for another child. My 2 1/2 year-old child has been diagnosed with mild apraxia. She is doing great and her delayed speech has almost caught up to her peers. However it is been implicated to me several times that the offspring of women either with diagnose lupus or elevated ANA havevbeen a higher incidence of disability, especially autism. So I am imagining a pregnancy putting myself at risk for a debilitating disease and possibly a child with a disability. Do you think do you offspring of people in my situation have a higher risk of a child with a disability? My husband and I are both professionals and Are seriously considering adoption, although of course I would prefer to carry a child if the risk is minimal. Do you agree that once 640 always 640 , even if the number has declined it is not significant in terms of lowering the risk.? I have been tested four times over the past two years. Moist recently 160 ANA. Thank you very much for your help.