HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Lupus

default
Posted on Mon, 24 Nov 2014
Question: Told I have an elevated ANA level today by my doctor. Have symptoms of joint swelling to feet and right hand with numbness with extreme joint pain and fatigue. any ideas if it could be anything beside lupus?
doctor
Answered by Dr. Naval Mendiratta (33 minutes later)
Brief Answer:
is it lupus

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well ANA positivity does not mean you have lupus. Ana can be positive in. 5 to 10,percent population without causing much symptoms. To diagnose someone as lupus you need to have more than just joint pains

1. Do you experience oral ulcers/hair fall/rashes over the face/photosenstivity

2. Has your ENA profile been done

3. Do you have any other blood reports done as well, the routine ones..

4. What about rheumatoid factor and anti CCP antibody

Do let me know these queries. Would be happy to help you out further

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Naval Mendiratta (33 minutes later)
I have had intermittent mouth sores that I had assumed were related to citrus/acidic foods. nothing else. Never would have thought twice of them til now. I have some itchy sores to bilateral deltoids which is new. I scratch they bleed- weird. The blood tests were done by my neurologist on my request because I had been taking a lot of nsaid for migraines. i started noticing bruising a few weeks back after foot massage- since resolved. I did take a brief dose of steroids in early August for migraines. Could this be causing the false positive???? otherwise it's just vitamin d, mag, relafen and treximet. Hey--maybe this is just crazy and i have fibromyalgia? I hear thAT IS BETTER TO HAVE

Also, live in NYC....any recommended f/u for treatment? thx
doctor
Answered by Dr. Naval Mendiratta (5 hours later)
Brief Answer:
? Is it Lupus

Detailed Answer:
Good evening

Sorry for delayed reply. The hospital duties started here

Considering your history and the symptoms, I really dont think it is lupus. For lupus to be classified, there has to be more of joint pains, rashes, oral ulcers, photosenstivity and some organ involvement as well.

To really classify it as Lupus, one needs to do a further subset of antibodies, which is done with ENA profile. It can detect upto 25 more antibodies which are of more relevance

Fibromyalgia is definitely a possibility but it is usually a diagnosis of exclusion. I would keep it last on my list, cause once you get labelled with the disease other doctors stop looking for the main reason.

If you could attach your other blood reports also, that would be more helpful.

Could you answer me few more queries regarding Fibromyalgia::

1. Do you feel irritable at times?

2. Do you feel fresh when you wake up in the mornings?

3. Do you have a tendency to forget things?

4. Is there lot of stress affecting your daily routine?

5. How about Bowel upset/increased urination/and increased urine in the nights?

Looking forward to your reply

Will try and guide you further..

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
default
Follow up: Dr. Naval Mendiratta (6 hours later)
Yes to all of above except the stress part. I do not feel that this is Lupus. I just picked up lab results. ANA is 180 and speckled. Mag 4.0 everything else normal. I am going to f/u with Rheumatologist here but until then wondering what else it could be. Realize that more blood work will be done an ENA- right? What else should I expect or is an ENA going overboard?
doctor
Answered by Dr. Naval Mendiratta (47 minutes later)
Brief Answer:
is it Lupus

Detailed Answer:
Good evening

ENA wont be overboard at all. ANA can be falsely positive in lot of individuals, even those with thyroid patients and 5-10 % of normal population. To relate your symptoms to only ANA +ve and labeling it as Lupus aint the right approach. ENA will give us a definite answer if ANA is pathogenic or not.

What i would suggest is to get it done once and for all. So it will clear the mind if it really Lupus or not. The symptoms i had asked you do point towards Fibromyalgia and the interesting thing is , ANA can be positive in Fibromyalgia as well( almost 15 %).

you can discuss with your rheumatologist about the cause. If it is really Lupus , i wouldnt want to leave you without treatment. You will need to be on steroids and Hydroxycholoroquine at least for controlling it.

As of now, i dont think you need to worry too much. We will get it sorted out.

Hope the information was useful

Do let me know for more queries you have. I would be happy to answer it.

Regards
Dr Naval

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Lupus

Brief Answer: is it lupus Detailed Answer: Good evening Thank you for writing on health care magic Well ANA positivity does not mean you have lupus. Ana can be positive in. 5 to 10,percent population without causing much symptoms. To diagnose someone as lupus you need to have more than just joint pains 1. Do you experience oral ulcers/hair fall/rashes over the face/photosenstivity 2. Has your ENA profile been done 3. Do you have any other blood reports done as well, the routine ones.. 4. What about rheumatoid factor and anti CCP antibody Do let me know these queries. Would be happy to help you out further Regards Dr naval