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Are SI Joint Degeneration, Vasculitis, Photosensitivity And Baker's Cyst Symptoms Of Lupus?
Question: I am wondering whether I have lupus. Over the last three years I have developed a number of non-specific inflammatory symptoms. Among them, doctors have noted the following: SI Joint degeneration, oseteophytes (in toes), photosensitivity (skin), photophobia (eyes), vasculitis (Raynaud's + livedo reticularis), oral ulcers, endometrial hyperplasia, inflamed joints and gums, baker's cyst, gastritis, and GERD. Hair loss and unintentional weight loss happens during flareups, and my memory and attention span go down the tubes and at times I can hardly breathe. Also developed new allergies to eggs, bactrin and clindamycin during this time. Apart from findings of vitamin D and B12 deficiencies, low ferritin, +VCA-IgG, + D early antigen and + EBNA, my blood work looks normal. Would greatly appreciate hearing your thoughts.
Brief Answer:
Yes there is definitely a possibility that you may be suffering from lupus.
Detailed Answer:
Dear Madam,
Thank you for posting your query on HCM.
Well looking at your problem and the symptoms that you are giving there is a very high possibility of lupus . It's not essential that autoimmune profile has to be positive , sometimes it may be negative initially and then becomes positive in due course of time . But still I would like to see what they have done already so I can suggest you further . I think you should not waste time and get in touch with your rheumatologist as soon as possible .
Take care.
Dr. Shruti
Yes there is definitely a possibility that you may be suffering from lupus.
Detailed Answer:
Dear Madam,
Thank you for posting your query on HCM.
Well looking at your problem and the symptoms that you are giving there is a very high possibility of lupus . It's not essential that autoimmune profile has to be positive , sometimes it may be negative initially and then becomes positive in due course of time . But still I would like to see what they have done already so I can suggest you further . I think you should not waste time and get in touch with your rheumatologist as soon as possible .
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thank you for your quick reply. I have had so many tests done over the last few years. In addition to comprehensive metabolic, cbc, vitamin, and allergy tests and ruling out Lyme disease, I had the following Lupus-related tests done. All with negative results. There might be more. I need to set up an Excel sheet!
Thanks again!
XXXXX
ERYTHROCYTE SEDIMENTATION RATE BY WESTERGREN METHOD on 12/11/2015
ANCA/VASCULITIDES 12/29/2015 (#199105, Final, 12/23/2015
12/23/2015 ANTIPHOSPHOLIPID ANTIBODY PANEL, SERUM.
12/11/2015 C-REACTIVE PROTEIN, QUANTITATIVE
Complement was also tested at some point in 2015
Lab: ANTI-MICROSOMAL Ab(THY.PEROX.) 01/10/2014
ANTI-TPO Ab <10 <35 IU/mL 01/10/2014
CARDIOLIPIN ANTIBODY PANEL - Final result (02/20/2014 10:22 AM EST)
ANTINUCLEAR ANTIBODY - Final result (02/20/2014 10:22 AM EST)
RUSSEL'S VIPER VENOM, DILUTED (RVVT) - Final result (02/20/2014 10:22 AM EST)
BETA-2 GLYCOPROTEIN ANTIBODIES - Final result (02/20/2014 10:22 AM EST)
CARDIOLIPIN ANTIBODY PANEL - Final result (02/20/2014 10:22 AM EST)
HLA-B27 ANTIGEN - Final result (02/20/2014 10:22 AM EST)
RHEUMATOID FACTOR - Final result (02/20/2014 10:22 AM EST)
I sent you a list of the lab work that was done, as you so requested. As I had mentioned, they all came out negative. Does this change your opinion? Are there other tests that you would recommend? I am scheduled to see a rheumatologist next Thursday.
Oh and one more non-specific symptom I neglected to remember -- I had a skin tag by my eye that quickly grew out of nowhere (had it removed). Is that related to lupus?
Thank you for your quick reply. I have had so many tests done over the last few years. In addition to comprehensive metabolic, cbc, vitamin, and allergy tests and ruling out Lyme disease, I had the following Lupus-related tests done. All with negative results. There might be more. I need to set up an Excel sheet!
Thanks again!
XXXXX
ERYTHROCYTE SEDIMENTATION RATE BY WESTERGREN METHOD on 12/11/2015
ANCA/VASCULITIDES 12/29/2015 (#199105, Final, 12/23/2015
12/23/2015 ANTIPHOSPHOLIPID ANTIBODY PANEL, SERUM.
12/11/2015 C-REACTIVE PROTEIN, QUANTITATIVE
Complement was also tested at some point in 2015
Lab: ANTI-MICROSOMAL Ab(THY.PEROX.) 01/10/2014
ANTI-TPO Ab <10 <35 IU/mL 01/10/2014
CARDIOLIPIN ANTIBODY PANEL - Final result (02/20/2014 10:22 AM EST)
ANTINUCLEAR ANTIBODY - Final result (02/20/2014 10:22 AM EST)
RUSSEL'S VIPER VENOM, DILUTED (RVVT) - Final result (02/20/2014 10:22 AM EST)
BETA-2 GLYCOPROTEIN ANTIBODIES - Final result (02/20/2014 10:22 AM EST)
CARDIOLIPIN ANTIBODY PANEL - Final result (02/20/2014 10:22 AM EST)
HLA-B27 ANTIGEN - Final result (02/20/2014 10:22 AM EST)
RHEUMATOID FACTOR - Final result (02/20/2014 10:22 AM EST)
I sent you a list of the lab work that was done, as you so requested. As I had mentioned, they all came out negative. Does this change your opinion? Are there other tests that you would recommend? I am scheduled to see a rheumatologist next Thursday.
Oh and one more non-specific symptom I neglected to remember -- I had a skin tag by my eye that quickly grew out of nowhere (had it removed). Is that related to lupus?
Brief Answer:
Follows.
Detailed Answer:
Dear XXXXXXX ,
You haven't given the value of results for each test but anyways I take that all of them are negative . Still you ENA profile , Coombs test , Anti TPO antibodies haven't been done . These tests and their values are often supportive and not conclusive so mere their negativity cannot be taken as exclusion of lupus . Your clinical features are highly supportive of lupus so may be we need repitition of tests . Let your rheumatologist see you once and opine then we can chalk out further course .
Dr. Shruti
Follows.
Detailed Answer:
Dear XXXXXXX ,
You haven't given the value of results for each test but anyways I take that all of them are negative . Still you ENA profile , Coombs test , Anti TPO antibodies haven't been done . These tests and their values are often supportive and not conclusive so mere their negativity cannot be taken as exclusion of lupus . Your clinical features are highly supportive of lupus so may be we need repitition of tests . Let your rheumatologist see you once and opine then we can chalk out further course .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX Thank you for your reply. I believe that some of the tests you mentioned are those which my doctor recently ordered, though not Coombs. Thank you for the suggestion. And yes, you were quite right -- all of the past tests came out negative. Figure rheumatologist will repeat them as you suggested. Think one of my questions was buried -- are skin tags related to lupus? Had one grow nearly over night on the corner of my eye about a year and a half. Had it excised. Might have more questions later. I appreciate your help. It is comforting to have answers after all of this time. Thank you!
Brief Answer:
Follows.
Detailed Answer:
Dear XXXXXXX ,
Skin tags are not related to lupus , they can be a normal thing or signs of hormonal imbalance , insulin resistance generally , so dont get bothered by that . We have a limitation that cant see you un person but can guide you with any question that comes to your mind . The autoimmune diseases are complex and dont go by what is written in literature , so the clinical acumen comes foremost . Thats why I want your rheumatologist to see you once and then i can guide you accordingly with any more questions you have . Also dryness of eyes and mouth is one common symptom, so get schirmers test done also .
Take care.
Dr. Shruti
Follows.
Detailed Answer:
Dear XXXXXXX ,
Skin tags are not related to lupus , they can be a normal thing or signs of hormonal imbalance , insulin resistance generally , so dont get bothered by that . We have a limitation that cant see you un person but can guide you with any question that comes to your mind . The autoimmune diseases are complex and dont go by what is written in literature , so the clinical acumen comes foremost . Thats why I want your rheumatologist to see you once and then i can guide you accordingly with any more questions you have . Also dryness of eyes and mouth is one common symptom, so get schirmers test done also .
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Deepak
Dear Dr. XXXXXXX
Thank you for answering my question about skin tags. Given the symptoms I have and have had over the last few years, can you think of any other condition that I could have besides lupus? I recognize that it might be difficult to know without seeing me in person, but i would appreciate any best educated guesses.
Thank you for your consideration.
XXXXX
Thank you for answering my question about skin tags. Given the symptoms I have and have had over the last few years, can you think of any other condition that I could have besides lupus? I recognize that it might be difficult to know without seeing me in person, but i would appreciate any best educated guesses.
Thank you for your consideration.
XXXXX
Brief Answer:
Follows.
Detailed Answer:
Dear XXXXXXX ,
Well it may not exactly be lupus but a variety of autoimmune disorders overlap each other like UCTD , MCTD , APS etc . but thats just a variation in clinical spectrum . So ,the whole symptoms are suggestive of underlying connective tissue disorder of which the prototype is lupus .
Dr. Shruti
Follows.
Detailed Answer:
Dear XXXXXXX ,
Well it may not exactly be lupus but a variety of autoimmune disorders overlap each other like UCTD , MCTD , APS etc . but thats just a variation in clinical spectrum . So ,the whole symptoms are suggestive of underlying connective tissue disorder of which the prototype is lupus .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Shupti,
Thank you for your helpful reply. Perhsps should have asked about this earlier, but i thought it would go away. Last Sunday I went swimming and managed 6 laps fhen lazed around in sunscreen for an hour or two. Arms, chest and neck turned beet red, but never felt hot or painful, so it was not like a regular burn, but on my neck, appeared a three inch slash that looked like a hicky, but felt like dry skin. Has almost gone away, but have beenrather wiped out since then -- out of breath with minimal exertion and my throat has been really sore ever since. Is this typical for photosensitivity?Also, found red bumps on back of tongue on the side and black dots behind that. Cannot take photo without gagging. Not sure if this is GERD related and/or typical of EBV reactivation and/or Lupus. Feeling like a hypochondriac, but I know this is all real. Thank you for your consideration.
XXXXX
Thank you for your helpful reply. Perhsps should have asked about this earlier, but i thought it would go away. Last Sunday I went swimming and managed 6 laps fhen lazed around in sunscreen for an hour or two. Arms, chest and neck turned beet red, but never felt hot or painful, so it was not like a regular burn, but on my neck, appeared a three inch slash that looked like a hicky, but felt like dry skin. Has almost gone away, but have beenrather wiped out since then -- out of breath with minimal exertion and my throat has been really sore ever since. Is this typical for photosensitivity?Also, found red bumps on back of tongue on the side and black dots behind that. Cannot take photo without gagging. Not sure if this is GERD related and/or typical of EBV reactivation and/or Lupus. Feeling like a hypochondriac, but I know this is all real. Thank you for your consideration.
XXXXX
Brief Answer:
Follows.
Detailed Answer:
Dear XXXXXXX ,
What ever history that you are giving is suggestive of photo sensitivity but whatever oral symptoms that you are telling cannot be attributed to lupus or any other thing until and unless we see it . But I would advise you to avoid sunlight exposure and use sunscreen with spf greater than 50 . As sun exposure can lead to exposure of lupus so avoid it .
Dr. Shruti
Follows.
Detailed Answer:
Dear XXXXXXX ,
What ever history that you are giving is suggestive of photo sensitivity but whatever oral symptoms that you are telling cannot be attributed to lupus or any other thing until and unless we see it . But I would advise you to avoid sunlight exposure and use sunscreen with spf greater than 50 . As sun exposure can lead to exposure of lupus so avoid it .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Shall stay out of sun. Managed to take a photo of back of mouth. Not a great shot, but then found another bump that looked different but was easy to photograph. Also included picture of neck "scar" and other pictures of "curiosities" that appeared that I have taken over time.
Shall stay out of sun. Managed to take a photo of back of mouth. Not a great shot, but then found another bump that looked different but was easy to photograph. Also included picture of neck "scar" and other pictures of "curiosities" that appeared that I have taken over time.
Brief Answer:
Follows.
Detailed Answer:
Dear XXXXXXX ,
I have gone through the pictures you have sent , not very clear though but yes you are having photosensitivity . Almost all connective tissue disorders have photosensitivity as their component and UV rays in sun can exacerbate existing disease so it's very important to avoid the sun exposure . These oral ulcers look aphthous ulcers rest your rheumatologist will be able to tell after examining the mouth . So presently we will go conservative and see what your doctor has to say about this and further testing .
Dr. Shruti
Follows.
Detailed Answer:
Dear XXXXXXX ,
I have gone through the pictures you have sent , not very clear though but yes you are having photosensitivity . Almost all connective tissue disorders have photosensitivity as their component and UV rays in sun can exacerbate existing disease so it's very important to avoid the sun exposure . These oral ulcers look aphthous ulcers rest your rheumatologist will be able to tell after examining the mouth . So presently we will go conservative and see what your doctor has to say about this and further testing .
Dr. Shruti
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Above answer was peer-reviewed by :
Dr. Raju A.T
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