View Full Version : it's me again....more confused and depressed than ever!

09-15-2006, 06:18 AM
Sorry to bother anyone. I posted a message awhile ago. I been having ALOT of pain in my left leg....since March....it started when I walked but when I got off it....it was better. Then...it was shorter distance when it hurt and still hurt when off of it. I asked my lupus dr. and she told me she didn't know! "I can't give you an answer" So I couldn't take the pain anymore and went to medical dr. who listened to my legs for pulses...I have no pulse behind my left leg...and very faint at the bottom...He sent me to a heart dr. who gave me a doppler. I do have plaque in both legs but I have blockage in my stomach.. so now looking at surgery...From what I'm told I have to get a stent put in stomach. The heart dr. seemed very concerned about my lupus...and sjrogren's syndrome. Does anyone know how much or if any lupus can be a factor in this??? I called my dr. the next day of my doppler results...and her exact words were that she was "totally shocked"....if anyone has any infomation...it would be DEEPLY APPRECIATED! Please help!

09-15-2006, 09:39 AM
Are your doctors thinking that you have leg artery disease (Peripheral arterial Disease)? Between 8 and 12 million Americans are affected by peripheral arterial disease, or PAD, where the arteries that bring blood to the legs are blocked by atherosclerotic plaque. P.A.D. occurs when extra cholesterol and other fats circulating in the blood collect in the walls of the arteries that supply blood to your limbs. This buildup—called plaque—narrows your arteries, often reducing or blocking the flow of blood.
P.A.D. is most commonly seen in the legs, but also can be present in the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. Nearly everyone who has P.A.D—even those who do not have leg symptoms—suffers from an inability to walk as fast or as far as they could before P.A.D.
Research has shown that SLE patient had a higher prevalence of traditional atherosclerosis (hardening of arteries) risk factors and P.A.D. is one form of atherosclerosis. People with lupus are prone to premature accelerated atherosclerosis
Here is a web-site about P.A.D. - www.aboutPAD.org.
I don't know if this answers your questions because I don't know what your doctors are thinking the problem might be. Let us know what your doctors say on your next visit and then, perhaps, we can do more research for you!
I wish you the best
Peace and Blessings

09-15-2006, 02:07 PM
Thanks again for your reply. Yes....dr. diagonsed me with P.A.D. and also have blockage in the illiac artery. I just wondered how much lupus can be contributing (if it is) to this problem. I have bloodwork to get done before surgery....lupus anticoagulant?....Anticardiolipine Ab's...and others that I cannot make out...do you know anything info of these blood tests?
Don't mean to bother you.....but just so upset anymore!
Thanks for your time!
God Bless!

09-16-2006, 05:20 AM
In a way, I guess you can say that Lupus contributes to your P.A.D. As I mentioned in my other post, Lupus patients have a higher incidence of hardening of the arteries (atherosclerosis) and P.A.D. is a form of atherosclerosis!!

With reference to Lupus Bloodwork:
Lupus anticoagulant testing is used to help determine the cause of an unexplained thrombosis (formation of blood clots), recurrent fetal loss, or a prolonged aPTT test (Partial Thromboplastin Time,To help evaluate your risk of excessive bleeding prior to a surgical procedure). It is ordered to help determine whether a prolonged aPTT is due to a specific inhibitor (an antibody against a specific coagulation factor), or to a nonspecific inhibitor, like the lupus anticoagulant. It may be ordered along with anticardiolipin antibody and anti-beta2-glycoprotein I assay to check for antiphospholipid syndrome. If someone tests positive for the lupus anticoagulant, the test may be done again in several weeks to see if the antibody was due to a temporary condition or is a chronic issue. Occasionally lupus anticoagulant testing may be ordered to help determine the cause of a positive VDRL/RPR test for syphilis (both anticardiolipin and lupus antibodies will test false positive with these tests).
Because there are other inhibitors and analytical variables that can cause abnormal test results, several different tests are used to confirm the presence of a lupus anticoagulant. Typically these may include: aPTT, prothrombin time (PT), dilute or modified Russell viper venom screen (dRVVT or MRVVT), and a hexagonal (II) phase phospholipid assay (Staclot-LA test) or kaolin clot time. A thrombin time test may also be done to rule out heparin contamination (this is a drug used for anticoagulant therapy), and a fibrinogen test may be done to rule out hypofibrinogenemia. These two conditions can cause prolongations in the test results and interfere with lupus anticoagulant detection.

Anticardiolipine Ab Test: This is a clotting test specifically designed to detect the lupus anticoagulant or by evaluating for the presence of the antibody. These blood tests are done by a blood sample that requires special handling in a coagulation laboratory for accurate diagnosis. to diagnose this disorder, two tests must be done on different occasions because the antibody may wax and wane. The clotting test is inaccurate in persons on blood thinners or with underlying bleeding disorders.
The lupus anticoagulant/ anticardiolipin antibody test may be positive in persons with infections, using antibiotics, or other medications and usually returns to normal when the infection is cleared or the medication stopped.

The Anticardiolipin Antibody Syndrome (Lupus Anticoagulant) is caused by an antibody response against phospholipid (a major component of the cell wall). The antibody response results in a heterogenous group of clinical conditions including blood clots, stroke, heart attack, low platelet count, spontaneous abortions, and vague neurologic symptoms. This abnormality was first identified as a prolongation of the clotting test (the PTT) in persons who had systemic lupus erythematosus, therefore the name lupus anticoagulant was coined. Although there is a high incidence of this in persons with lupus, it occurs in many persons without lupus and does not predict future development of lupus. Although some persons have prolongation of clotting tests, they do not bleed but are instead prone to the development of blood clots.Persons with this disorder may be asymptomatic or have various syndromes. Affected persons may have recurrent blood clots involving the heart and resulting in a heart attack, involving the vessels to the brain and resulting in a stroke or other neurologic symptoms, or involving the vessels feeding the developing fetus in pregnant women resulting in miscarriage. The blood clots may also occur in the extremities (deep vein thrombosis) or lung (pulmonary embolus).

I hope that I have answered your questions. I wish you the best!
Peace and Blessings

09-20-2006, 03:16 PM
not all my blood work came back yet....dr. said it may take a few more days.......but I don't know exactly the name of tje test it's
" homo-something "came back high....and said it may cause clotting?! I should take 2 tabs. of folic acid a day and have another blood test again in a month.....my other tests results are pending. Dr. said this can be a factor with the problem of the hardening of arteries and the blockage..I don't know what to do anymore.....I got diagonsed in March of this year with lupus...from then its' been very high bad chlorestrol.....hardening of arteries....blockage in my illiac artery......I am so scared what's next......especially that I don't understand what is going on anymore!!!!!

09-20-2006, 04:51 PM
when your body starts doing things you can't control - it's scary - don't ever feel you need to apologize for that!

Your doctor is probably talking about your homocysteine levels. Homocysteine is a sulfur-containing amino acid that has linked to increased risk of premature coronary artery disease, stroke, and thromboembolism (venous blood clots), even among people who have normal cholesterol levels. Abnormal homocysteine levels appear to contribute to atherosclerosis (hardening of the arteries) in at least three ways: (1) a direct toxic effect that damages the cells lining the inside of the arteries, (2) interference with clotting factors, and (3) oxidation of low-density lipoproteins (LDL).

Blood for measuring serum homocysteine levels is drawn after a 12-hour fast. Levels between 5 and 15 micromoles per liter (µmol/L) are considered normal. Abnormal concentrations are classified as moderate (16-30), intermediate (31-100), and severe (greater than 100 µmol/L).

The connection between homocysteine and cardiovascular disease was suspected about 25 years ago when doctors noticed that people with a rare condition called homocystinuria often develop severe cardiovascular disease in their teens and twenties. In this condition, an enzyme deficiency causes homocysteine to accumulate in the blood and to be excreted in the urine. Recent studies suggest that elevated blood homocysteine levels are as important as high blood cholesterol levels and can cause cardiovascular disease even in people with normal cholesterol levels. Some 10% to 20% of cases of coronary heart disease have been linked to elevated homocysteine levels.

Folic acid can reduce elevated homocysteine levels in most patients. The usual therapeutic dose is 1 mg/day. When this is not effective, vitamins B6 and/or B12 can be added to the regimen. Your doctor will probably monitor your homocysteine levels regularly.

Hope this helps clear up some of the confusion.