Lupus questions

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Kkaykkay
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 7/16/2018 6:42 AM (GMT -6)   
Hello,

Ana Panel:
Antinuclear Ab: POSITIVE A
ANA Titre: 640
ANA Pattern: Speckled
ENA Screen: Negative
DNA double strand Ab: < 1 IU/mL ( < 5 )
Comment: A speckled pattern may be seen in several diseases including SLE, Sjogren's syndrome, subacute cutaneous lupus and scleroderma.
Frequency of positive (usually low titre) ANA increases with age and has higher incidence in the female population.

Please note: As of the 1st May 2017, this assay is performed on the BioRad
BioPlex. Changes in quantitative results between our previous EIA assay
(or other platforms) and this assay may not be clinically significant.

Anti-dsDNA Interpretation

0-4 Negative
5-9 Indeterminate
>= 10 Positive

Please note : ENA screen is able to detect antibodies against SSA/Ro,
SSB/La, Sm, RNP, Jo-1 and Scl-70. <<<<<<<<<


Negative ENA and dsDNA in the presence of positive ANA does not exclude the diagnosis of connective tissue disease.
--------
These were my results, I also have low iron stores count without anemia (haemoglobulin problems)
Iron Studies:
Ferritin: 9 ug/L ( 20 - 170 ) L
Comment: The low serum ferritin indicates depletion of iron stores.

----
Brackets indicate the average normal range.

I also have test results for:
Serum B12 and Folate, Liver function tests, lipid tests, calcium/phosphate, thyroid function tests, renal function tests, magnesium, coagulation tests, complete blood count.

All of these showed results expected in the physiologically normal ranges. (eg. I am not classified as anemic)

---------
Anything in brackets is the physiological norm, and all below tests were within that range.


Urine Biochemistry:
Sample Type: Timed Urine Sample
Creatinine urine: 1.5 mmol/L
Protein urine: 0.02 g/L
Protein/Creatinine ratio: 13 mg/mmol ( < 23 )
Diagnostic criterion for proteinuria in pregnancy:TP/Cr ratio > 30
mg/mmol.
-----------------
Esr:
ESR: 5 mm/hr ( < 18 )
-----------------
Rheumatoid Factors:
RF Immunoturbidometric: < 9 IU/mL ( < 16 )
-----------------
C-Reactive Protein
CRP: < 1 mg/L ( < 5 )
------------
Autoantibodies:
Parietal Cell Ab: Not detected
Smooth Muscle Abs: Not detected
Mitochondrial Ab: Not detected

-----------
My Ana Panel was retested to make sure, but everything is physiologically normal:

Ana Panel:
ENA Screen: Negative
DNA double strand Ab: < 1 IU/mL ( < 5 )

Please note: As of the 1st May 2017, this assay is performed on the BioRad
BioPlex. Changes in quantitative results between our previous EIA assay
(or other platforms) and this assay may not be clinically significant.

Anti-dsDNA Interpretation

0-4 Negative
5-9 Indeterminate
>= 10 Positive

Please note : ENA screen is able to detect antibodies against SSA/Ro,
SSB/La, Sm, RNP, Jo-1 and Scl-70.

----

_______
My symptoms:
- so freaking darn tired all the time (sorry for the bluntness), sometimes even 12hrs sleep and still tired
- butterfly-lookalike (but most likely not it) face rash sometimes
- no joint or inflammation or swelling but my toes tend to get in a state where they're 'stuck' and it hurts so much and takes like 5min massaging them for it to stop, occurring in cold air or swimming
- raynaud's syndrome on two fingers on one hand and one on other while one toe each on feet, doesn't occur often, maybe once every 2-3months and not all at once, my mother also gets them
- generally feel cold, hands are cold almost always, but on the other hand I sometimes get strong night sweats
- headaches, and eyes hurt looking at lighted up things, tend to look at the ground.. Like while driving, looking at the tail lights hurts, same with looking at a TV with the room lights turned off
- I've had one to two swollen lymph nodes below the ear for like 4 years after having an asymptomatic fever that went around apparently
- heavy blood loss during first few days of periods - but it occurs at irregular intervals, have had a 6month no period situation due to apparent stress
- I began having these sudden acute stabbing pains not related to periods (much worse than any of those related to them) in the area slightly left of the belly button at the level where one is thinnest (quite above the hips, almost where the joint ribs end. This lasts for maybe 2min where I am in excruciating pain and then leaves suddenly, I can't even bare to move or even breathe, any movement irritates it even more
- when exercising (mind you I am not a fit person) my lungs begin to feel really dry and my heart begins to hurt like someone is clenching it, and unconsciously I press my hand against my chest to dull the pain which doesn't work
- I have the opposite of not being able to sleep (I can't wake up, sometime feels like I'm in an induced coma)
- I have anxiety but more like depression (major depressive syndrome probably)
- dry eyes sometimes yes, red whites if eyes occasionally
- I have to go to the bathroom a lot as soon as I drink more than a cup of water (1 cup = 3x bathroom within 2-3hrs)
- no rashes etc, only birth marks that look like the pale skin mixed with darker skin, and occasional new lentils popping up on my skin
- no known family member with lupus or autoimmune conditions, mainly only cancer and memory problems with some heart problems
- I have concentration ability problems that I didn't used to have when I was younger
- I am also quite sensitive to certain chemicals, eg washing soaps etc, I have to use organic otherwise my skin on my hands dries and causes bump rashes between my fingers, or dry scalp. Also occurs with citric fruits, have to wash the outside skin well before I can peel anything, eating them is fine
- I am young, so possibly some premature condition
- also over one summer I think 5 years ago, without being stressed at the time, I lost an unnatural amount of my hair, maybe 1/3rd of the total and my hair also thinned a lot, I've never dyed it etc.
- I also have lower back pain that feels like it's in the bones but is in the muscle tendon extension instead, that occurs once every few months - I usually think it's from some cold air conditions but I feel like I'm too young for this to occur die to cold haha (sorry)


I basically listed anything I could think of, most is probably unrelated to anything but yeah..
Let me know your thoughts please

The more I look at it the more I am finalising that it is not lupus or anything else unless it is such an early, premature situation that it could turn into anything or nothing at all. But the tiredness is really stressful..

Post Edited (Kkaykkay) : 7/16/2018 3:51:59 PM (GMT-6)


beave
Veteran Member


Date Joined Mar 2007
Total Posts : 1827
   Posted 7/17/2018 12:59 AM (GMT -6)   
What doctor ordered all of your tests? Was it a primary care/family doctor, or a rheumatologist?

Have you seen a rheumatologist? If not, you should do so.

It's doubtful that this is full SLE (lupus). This could be UCTD - Undifferentiated Connective Tissue Disease. The relatively high ANA result but negative results for others is common with UCTD. But you really need a rheumatologist to go over your results and your symptoms in detail before getting a diagnosis.

Kkaykkay
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 7/17/2018 1:25 AM (GMT -6)   
Thank you for replying ~

The tests were performed based on the second opinion of a rheumatologist but were asked to be performed by my primary care doctor. Primary care doctor has asked that I come see them again before possibly referring me to the rheumy

beave
Veteran Member


Date Joined Mar 2007
Total Posts : 1827
   Posted 7/17/2018 2:00 AM (GMT -6)   
In that case, I do recommend you go see your primary care and get that referral to the rheumatologist.

Kkaykkay
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 7/17/2018 6:31 AM (GMT -6)   
It's the tiredness with too much sleeping and unable to wake up that really bothers me, especially the unable to concentrate situation.. Although this might be explained by the low iron stores which I've been trying to restore for the 6 months now (without supplements, just change of diet, might ask them to recheck that)
... followed by the massive acute stomach area pain I get sometimes. At first I thought it could be the appendix but it's not near that area from what I've found out.
Quite serious loss of appetite as well most days too..
The depression and anxiety (which I recently realised wasn't a simple describing factor for a tiny time but for like 3 years now) is also quite uhh annoying, for the lack of a better word)

And it also looks like my hands swell slightly in response to cold temperatures hm, taking quite a while for them to warm up again even under warm water, and the process goes through an almost pins and needles/numbness situation

And that bland feeling of unwellness is mostly constant - I heard they have a name for that now which is interesting

This was the details of th blood counts (brackets indicate the norm levels) and although most are in the lower part of the norm, I don't think that makes much of a difference unless it's the borderline, so again no real anemia present:

Complete Blood Count
Haemoglobin: 135 g/L ( 115 - 155 )
RBC: 4.87 x10e12/L ( 3.60 - 5.60 )
HCT: 0.42 L/L ( 0.35 - 0.46 )
MCV: 85 fL ( 80 - 99 )
MCH: 27.7 pg ( 27.0 - 33.0 )
Platelets: 244 x10e9/L ( 150 - 400 )
WBC: 5.7 x10e9/L ( 4.0 - 11.0 )
Neutrophils: 3.35 x10e9/L ( 1.90 - 7.50 )
Lymphocytes: 1.92 x10e9/L ( 1.00 - 4.00 )
Monocytes: 0.38 x10e9/L ( 0.20 - 1.00 )
Eosinophils: 0.07 x10e9/L ( < 0.51 )
Basophils: 0.02 x10e9/L ( 0.00 - 0.20 )

GreenBeans
Regular Member


Date Joined Dec 2016
Total Posts : 46
   Posted 7/21/2018 9:50 PM (GMT -6)   
With your ANA of 1:640, and the various symptoms you list, I strongly suggest you have an evaluation by a rheumatologist -- these are the Drs who really know about auto-immune diseases and know how to diagnose and treat the diseases that show up with positive ANA results.

Other Drs only have a cursory introductory knowledge of these illnesses, and you really need a workup by a rheumy to figure out what, if anything, is going on.

Kkaykkay
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 7/21/2018 9:56 PM (GMT -6)   
Thank you for replying, yea I am visiting the primary doctor on Wednesday who will most likely refer me to the rheumy as stated in their recent email to me, I'll msg any updates afterwards smile I might also ask for another complete blood count and to recheck those iron store problems I had (as these test results are from February this year, there hasn't been any significant change since then at least visually.
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