02-06-2009, 03:33 PM
Okay so I just had a quick question about antibodies. My blood work was positive for SLE antibodies and then they found the SCL-70. Well I researched it and SLE is more signinfcant in lupus patients and SCL is systemic sclerosis(aka scleroderma). They both are AI's that affect the skin seems like the SCL affects internal organs more. Anyone know more about this? Can you have both?
02-07-2009, 10:03 AM
I know the following information is a lot, but I wanted to provide to you what Scleroderma is from my research...especially because there are two types of scleroderma and two sub categories of the one and not just systemic.
And to prevent less worrying about the tests before a diagnose is reached...I hope I have. Maybe you have read all this....
Organ involvement..one more so than another? I have not read any statistic yet but I have come across once diagnosed with systemic scleroderma the progression of the disease in one study. I can post if you like...
Hope the following helps..information pulled from various sites.
I do not have scleroderma...I tested negative for it being the cause of my esophageal motility dysfunction..aka...dysphagia.
In order to perform the anti-SCL-70 test a positive ANA must be met. Which you seemed to have...
20-60%..percentage varing from lab to lab..chances are it is Scleroderma. That would mean there is also a 40 -80% it isn't...
The American College of Rheumatology classification of scleroderma requires one major or two minor criteria for the diagnosis.
Major Critera - Proximal scleroderma where the skin proximal to the metacarpophalangeal joints in the hand or the metatarsophalangeal joints in the foot is indurated, thickened, and hard and is often shiny with loss of skin surface markings. Loss of skin elasticity also occurs. A "salt and pepper" pattern of hyperpigmentation (excess pigmentation of the skin) and hypopigmentation (reduced pigmentation of the skin) is common.
o sclerodactyly - stiffness and tightening of the skin of the fingers
o digital pitted scars or loss of substance of the finger pad
o bibasilar pulmonary fibrosis - fibrosis of the base of both lungs that is evident on a chest X-ray.
The diagnosis of scleroderma is approximately 97% accurate with one major or two minor criteria present.
There are several conditions in which scleroderma-like skin lesions may appear in conjunction with other conditions. These are called "overlap syndromes" and include:
* Systemic lupus erythematosus
* Rheumatoid arthritis
* Eosinophilic fasciitis
* Mixed connective tissue disease
Other conditions that have to be considered and excluded in the differential diagnosis of systemic scleroderma include:
* Primary Raynaud's phenomenon
* Drug effects (such as bleomycin, ergot derivatives, beta blockers, methysergide)
* Chemical exposure (such as vinyl chloride)
* Injury to blood vessels due to the use of vibrating tools (such as jackhammers)
There are two type of scleroderma...
1. Localized scleroderma affects only the skin.
2. Systemic scleroderma also harms internal organs, such as the heart, lungs, kidneys and digestive tract. This type of scleroderma, affects not only your skin but also your blood vessels and internal organs. Subcategories are defined by what portions of your body are affected.
Then the Systemic scleroderma has two sub categories that can be differentiated by the extent of skin involvement...
1. limited systemic scleroderma
2. diffuse systemic scleroderma.
Once the presence of scleroderma has been definitely established, it is important to determine:
* Type of scleroderma
* Extent of organ involvement
* Degree of tissue damage
Signs and Symptoms of Scleroderma
Initial signs and symptoms vary with the different types of scleroderma. For localized scleroderma, the first symptom usually appears spontaneously and is most often a red, swollen area on the skin characterized by hair loss, and anhidrosis (reduced sweat response). There is no pitting of the skin in the affected area.
The onset of systemic scleroderma is more pronounced and the symptoms are more diffuse. These may include:
Calcinosis - deposits of calcium crystals under the skin around the joints and organs. Skin ulcers may form over these areas.
Raynaud's phenomenon - numbness, pain or color changes in the extremities brought on by cold temperatures or emotional stress. This is caused by changes in the small arteries and capillaries resulting in constriction and a temporary disruption of circulation, usually in the extremities (fingers, toes, nose and ears). This is often the first symptom of systemic scleroderma.
Esophageal motility dysfunction (dysphagia) - muscles in the esophagus are unable to contract normally due to scarring. This can cause heartburn or a sensation of food being stuck in the throat or chest. It is estimated that up to 90% of patients with systemic scleroderma have esophageal involvement.
Sclerodactyly (acrosclerosis) - stiffness and tightening of the skin of the fingers. Bone loss may also occur in the fingers and toes. This symptom is usually found distal to the elbows and knees and may or may not involve the face.
Telangiectasia - dilation of the small vessels and capillaries near the skin surface causing flat red marks on the palms of the hands, face, and tongue.
Progressive thickening, hardening, and tightening of the skin (fibrosis) especially on the arms or hands, resulting in loss of flexibility. In limited systemic scleroderma, skin thickening is usually limited to the hands and face.
Swelling and/or itching of the skin of the hands, feet, chest or face.
Curling (flexion) and stiffening of the fingers
Stiffness or pain in muscles and/or joints especially in the morning. This pain is usually worse than what would be otherwise expected from a generic inflammation. This is often an early symptom of systemic scleroderma.
Sores over the joints such as the elbows and knuckles
Digestive difficulties from both impaired absorption of nutrients and muscular activity in the intestine
Shortness of breath
Constipation or diarrhea
Fatigue and weight loss
Depression (studies show up to 50% of patients with systemic scleroderma develop moderate to severe depression)
Sjogren's syndrome - an autoimmune disorder characterized by dry eyes, dry mouth, dry skin, joint stiffness and fatigue. Approximately 1% of patients with systemic scleroderma develop Sjogren's syndrome.
02-07-2009, 04:58 PM
Thank you for all your research I truly appreciate it. I have read some of this before too. Well Monday is the 2nd opinion so I will wait to see then. :)
02-09-2009, 02:52 PM
How did the second opinion appointment fair, SpanglishQueen? Hope all news was good news...