Lupus or not Lupus?

Posted by toomanyoars @toomanyoars, Oct 25, 2018

8 years with either wild goose chases, no tests and it's stress or tons of expensive tests and we don't know. Consistently they look for Lupus. I had 3 years of ANA positive results then switched doctors (insurance reasons) to end up with a new doc and new labs that show ANA negitive every time. So then obviously no lupus, right? Now 7 months of fever...still ANA negitive they think maybe lupus was the right diagnosis but until it shows positive they run more tests. Epstein Barr, Cytomegalovirus, Thyroid panels, etc. I have a fibromyalgia diagnosis but so many other symptoms don't fit so I am in a constant loop and feeling worse every day and more frustrated. I am not sure what to do next. Another doc, another lab, give up and quit trying to find out why I am so sick?

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@pkh3381

Hey, I have had 3 positive ANA/Lupus tests, too, and still told I don't have Lupus, but they don't come up with anything else, either. Nor do they seem sincerely interested in exploring anything! I just continue to have problems. I also had another experience with 5 CRP tests [for inflammation]. Four of the tests came back with results ranging from 5.9 to 8.5, but the only one that actually registered as High was the 8.5. When I had the 5th test come back as 5.9 and indicating as High, I contacted the Dr who ordered the test. I gave him the dates of the other tests and the results that showed at 5.9 and plus, and asked him if the reference range has changed for this test because the first 5.9 result and other higher results did not come back as High. He messaged me back & told me to check with the rheumatologist he had referred me to at one time, so I did so. The rheumatologist told me that I would have to check back with the Dr who ordered the test!! And, so it goes! I am so tired of the runaround and no answers!! I think the Drs have gotten themselves so overburdoned with patients that they are a disservice to all they serve! Just saying!
P

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I have been all over the map with auto-immune disease symptoms, tests, etc., and I will add this: I was constantly looking for a specific diagnosis. I just wanted an answer. What I've learned is that it isn't that easy. There isn't a specific treatment even if you get a specific diagnosis. They treat symptoms, not the disease itself. For me, I had doctors that said probably Lupus, a doctor that said sjogrens, etc. But the bottom line turned out to be that it really doesn't matter which of the hundreds of auto-immune diseases it is because they treat the symptoms, not the disease. At least this has been MY journey. So after years of not knowing specifically which auto-immune disease I had, and being treated for a lot of various symptoms (usually with prednisone), I ended up having 2 heart attacks. A heart biopsy verified that I have lymphocytic myocarditis, and I received a heart transplant. But I also have various other auto-immune diseases, including psoriatic arthritis, fibromyalgia, and a few others. Again, when symptoms flare up, they get treated. I hope this is helpful for those that just want an answer. Sometimes, there isn't a specific answer. And I'm ok with that now that I truly understand how it works with treatment.

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@michelecallahan

I have been all over the map with auto-immune disease symptoms, tests, etc., and I will add this: I was constantly looking for a specific diagnosis. I just wanted an answer. What I've learned is that it isn't that easy. There isn't a specific treatment even if you get a specific diagnosis. They treat symptoms, not the disease itself. For me, I had doctors that said probably Lupus, a doctor that said sjogrens, etc. But the bottom line turned out to be that it really doesn't matter which of the hundreds of auto-immune diseases it is because they treat the symptoms, not the disease. At least this has been MY journey. So after years of not knowing specifically which auto-immune disease I had, and being treated for a lot of various symptoms (usually with prednisone), I ended up having 2 heart attacks. A heart biopsy verified that I have lymphocytic myocarditis, and I received a heart transplant. But I also have various other auto-immune diseases, including psoriatic arthritis, fibromyalgia, and a few others. Again, when symptoms flare up, they get treated. I hope this is helpful for those that just want an answer. Sometimes, there isn't a specific answer. And I'm ok with that now that I truly understand how it works with treatment.

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To @michelecallahan, thank you for your reply and totally grasp the concept of what you are saying. I agree that a specific dx is not necessary, but my Drs are not even treating the symptoms!!
P

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@pkh3381

To @michelecallahan, thank you for your reply and totally grasp the concept of what you are saying. I agree that a specific dx is not necessary, but my Drs are not even treating the symptoms!!
P

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Then I would say it's time for a new doctor! It's so important to find the right doctor(s) and have that trust that they are working FOR you. If not, it's time to move on and find the right person. Good luck on your journey!

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@thecyborgenchi

I had 28 tests done. I'll list them as I see on the paperwork, many apologies - it's lengthy šŸ˜€ I will also put the results of any of them that showed up as anything other than normal in parenthesis. I was never tested for Covid when I believe I had it, but that is included in the blood work below. Side note: I don't know if I'm allowed to throw this info out there, but at this point I don't mind that people see my info, so... *shrug*

TSH, serum or plasma
CBC w/auto diff (of the 20 parts of this: platelet count was high)
T3, free, serum or plasma
T4, total, serum
vitamin B12, quant, blood
SARS CoV 2 IgG Ab, QN IA, serum or plasma (1 part: high - confirms I had Covid, if I'm not mistaken)
estradiol, serum
progesterone, serum
dhea-sulfate, serum
testosterone, total, serum
Ih + FSH, serum
lipid panel, blood (of the 16 parts: HDL cholesterol low, LDL particle number high, LDL small high, LDL medium high, LDL peak size low, hs CRP high)
HbA1c (hemoglobin, A1c), blood
insulin, serum
C-peptide, serum
CMP, serum or plasma (of the 18 parts: urea nitrogen [BUN] low)
urinalysis, dipstick
CK (creatine kinase), total, serum
magnesium, serum or plasma
vitamin D, 25-hydroxy, total, serum (1 part: low at 23 - but I knew this already)
iron + TIBC + ferritin, serum
uric acid, serum or plasma
erythrocyte sedimentation rate by westergren method
ANA (antinuclear antibodies) panel, serum (of the 3 parts: ANA screen - ifa positive/abnormal, ANA titer - 1:40 high, ANA pattern - nuclear, speckled/abnormal)
rheumatoid factor, qualitative, serum
CRP, high sensitivity, serum or plasma
anti-C1Q Ab, serum
systemic lupus erythematosus profile
lupus anticoagulant, plasma (of the 4 parts: anticoagulant not detected, drvvt screen high by 1 point)

And there you have it. Again, I'm not a professional by any means, but I like to think that I am intelligent enough to understand things, especially when I do the research that explains what it means. I've looked up the results of every one of these and the one that worries me the most is the ANA panel - it does NOT say normal, soooo... ?! According to what I've read, those results are indicative of lupus, if nothing else, further testing. I just called my doctor's office (they never answer) and left a message, telling them I want a referral to a rheumatologist, and provided the name and location of the one I chose that my insurance covers. She is 2 hours away, but I expected that.

Thank you for responding, by the way. I am finding that the support I'm receiving here is helping tremendously. I start crying every time I see someone has responded with kind words, encouragement, resources... it doesn't matter. My feelings of "I must be insane" start to go away, and that's important to me. I'm NOT crazy (not in this regard anyway lol). I'm NOT imagining these symptoms. My quality of life has tanked and I just want answers and some goals to work toward getting better, you know?

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No, you are not crazy. It isn't "you". Sometimes it isn't even the doctors. I posted months ago now, about finally being diagnosed with Serum Negative RA. Three years ago. He was a rheumatologist, he was just the best. After so many years of the revolving doctors who also get frustrated, I could not believe what he was telling me. He was much younger, not that matters, but I think it may help. He also was personable. He told me, that too many doctors rely only upon lab tests. He said you limit your patient's when you do that and you are not fair to them. I saw him for one year. I started the long road to better health. You always have to start at the beginning with the drugs. So, Methotrexate was up. It helped my energy level which was so poor. As you all know, autoimmune diseases, no matter what they are, sap you until you cannot move. Then, he resigned from that practice and moved. UTSW is a long painful and difficult trip for me. I can't drive, which means getting Medicare transportation. So, I stayed with that group and went to another rheumatologist. She was just terrible. She did not believe I had RA. She gave me Meloxicam, which I had years before etc. Anyway, I called his new office and it took me six months to get in. In that time, my knees, which had never hurt, became agonizing. It crippled me. By the time I saw him in July 2023, he didn't even bother with anything else and put me on Humira injections. My brother takes them for Psoriasis, and claims they did not work. That isn't true, FYI, because he cleared up. It does take a while but by the fourth injection, I could walk. And that was without pain. That was at Thanksgiving. He did repeat blood work, and it was the same. My hands were becoming deformed and they and my feet were bothering me more. But my knees had just ruined my life. So, here is the thing. After injection six, I noticed I was sliding backward. My hands and feet were worse, my jaw, where I have one arthritic joint was very painful, and my energy level went downhill. I was laying in bed all day on some days. Something I had never done. Well, this same great doctor, resigned from THAT practice and went to do clinical trials. My knees, although not as painful, I knew had to at least do something about that so I went to an orthopedic doctor. He was concerned about my other issues and also told me both knees needed to be replaced. He recommended a friend of his who was a Rheumatologist. So, I thought, sure, why not? He called him personally and asked him if he would see me. So, two weeks later, I went to see Dr. Cohen at Christus Mother Francis in Tyler, Texas. He was much older, but he did not miss a thing. He read my entire history printed it off to study, and asked me everything. I told him things I was having problems with I had never told anyone. So, he took a lot of blood. Those 28 tests you mentioned. It was the first time I had ever had those tests run. Ever. By anybody. It took ten days to get the results, including a weekend. And I do read all my tests and doctors' notes. Always. And, was I shocked? I have Lupus. And I have the RA in my hands and my feet and my knees and ......Do you know what the Lupus Foundation of America calls Lupus? The cruel mystery. They use purple ribbons. Now, I am 72. How long have I had it? Who knows? My guess is from the time I was in my late thirties. I remember the pain and all the medicines and struggling to work and all the side effects. I thought I was crazy. It couldn't all be aging. I am not saying that is what you have, only a doctor can tell you. But don't stop asking. Talk to them about all the autoimmune diseases. Lupus, there are different kinds. And, btw, I never had the butterfly rash they look for. But my skin cannot take the sun. I just bought a book entitled The Lupus Encyclopedia. And in his preface, the doctor talks about the terrible challenge for doctors and patients. Not everybody has the same thing. And some women were borderline. But they take meds. I hope, really, any of this helps.

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@thecyborgenchi

I had 28 tests done. I'll list them as I see on the paperwork, many apologies - it's lengthy šŸ˜€ I will also put the results of any of them that showed up as anything other than normal in parenthesis. I was never tested for Covid when I believe I had it, but that is included in the blood work below. Side note: I don't know if I'm allowed to throw this info out there, but at this point I don't mind that people see my info, so... *shrug*

TSH, serum or plasma
CBC w/auto diff (of the 20 parts of this: platelet count was high)
T3, free, serum or plasma
T4, total, serum
vitamin B12, quant, blood
SARS CoV 2 IgG Ab, QN IA, serum or plasma (1 part: high - confirms I had Covid, if I'm not mistaken)
estradiol, serum
progesterone, serum
dhea-sulfate, serum
testosterone, total, serum
Ih + FSH, serum
lipid panel, blood (of the 16 parts: HDL cholesterol low, LDL particle number high, LDL small high, LDL medium high, LDL peak size low, hs CRP high)
HbA1c (hemoglobin, A1c), blood
insulin, serum
C-peptide, serum
CMP, serum or plasma (of the 18 parts: urea nitrogen [BUN] low)
urinalysis, dipstick
CK (creatine kinase), total, serum
magnesium, serum or plasma
vitamin D, 25-hydroxy, total, serum (1 part: low at 23 - but I knew this already)
iron + TIBC + ferritin, serum
uric acid, serum or plasma
erythrocyte sedimentation rate by westergren method
ANA (antinuclear antibodies) panel, serum (of the 3 parts: ANA screen - ifa positive/abnormal, ANA titer - 1:40 high, ANA pattern - nuclear, speckled/abnormal)
rheumatoid factor, qualitative, serum
CRP, high sensitivity, serum or plasma
anti-C1Q Ab, serum
systemic lupus erythematosus profile
lupus anticoagulant, plasma (of the 4 parts: anticoagulant not detected, drvvt screen high by 1 point)

And there you have it. Again, I'm not a professional by any means, but I like to think that I am intelligent enough to understand things, especially when I do the research that explains what it means. I've looked up the results of every one of these and the one that worries me the most is the ANA panel - it does NOT say normal, soooo... ?! According to what I've read, those results are indicative of lupus, if nothing else, further testing. I just called my doctor's office (they never answer) and left a message, telling them I want a referral to a rheumatologist, and provided the name and location of the one I chose that my insurance covers. She is 2 hours away, but I expected that.

Thank you for responding, by the way. I am finding that the support I'm receiving here is helping tremendously. I start crying every time I see someone has responded with kind words, encouragement, resources... it doesn't matter. My feelings of "I must be insane" start to go away, and that's important to me. I'm NOT crazy (not in this regard anyway lol). I'm NOT imagining these symptoms. My quality of life has tanked and I just want answers and some goals to work toward getting better, you know?

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You are not crazy, and props to you for advocating for yourself and asking for a referral to a rheumatologist. Thatā€™s a great next step, and also donā€™t be afraid to keep asking and change rheumatologists if you donā€™t feel theyā€™re the right fit.

I donā€™t have lupus, but I have an autoimmune arthritis called seronegative spondyloarthropathy. Pain can be severe even though lab tests for all the inflammatory markers are normal. Joint damage from x-rays or MRIs may take years to be revealed to ā€œproveā€ the diagnosis.

Suffice it to say, it was very difficult for me to get a correct diagnosis. I was seen at Mayo Rochester for a full workup after seeing three rheumatologists in Chicago at major medical centers, and the rheumatology team at Mayo misdiagnosed me.

I can relate to that feeling of being crazy. After all, if the great and powerful Mayo concluded there was ā€œlow suspicionā€ of an inflammatory or autoimmune condition, then clearly I must be crazy, right?

We all deserve quality of life and healthcare providers who believe and will support us, to help find answers, but also to help us connect to the best fit treatment as well. Wishing you all the best!

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