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Thread: UTI and flank pain, want some in sight.

  1. #11
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    It is not uncommon for Lupus to cause swelling and inflammation in the lymph nodes. The body's immune system is a network of cells and tissues responsible for clearing the body of invading foreign organisms, like bacteria, viruses, and fungi. Antibodies are special immune cells that recognize these foreign invaders, and begin a chain of events to destroy them. In an autoimmune disorder like Lupus, a person's antibodies begin to recognize the body's own tissues as foreign. Cells and chemicals of the immune system damage the tissues of the body. The reaction that occurs in tissue is called inflammation. Inflammation includes swelling, redness, increased blood flow, and tissue destruction. One of the systems that often becomes swollen in Lupus are the Lymph Nodes.
    However, there are, also, a large number of conditions that could cause swollen lymph nodes; bacterial and viral infections are among those conditions. It is hard to say which factor is the cause, in your case.
    Inflamed nodes by themselves are not a major concern, but since you have symptoms of Lupus along with enlarged lymph nodes, this should be of some concern to your doctor.
    You should be concerned under the following circumstances:
    * If the swelling of the nodes lasts for more than 2 weeks or you have any symptoms such as weight loss, night sweats, fatigue, or prolonged fever.
    * If the nodes are hard, fixed to the skin, or are growing rapidly.
    * If you can feel swelling close to your collarbone or in the lower part of the neck.
    * If the overlying skin is red and inflamed and you suspect an infection.

    Now, If infection is the cause of your swollen lymph nodes and the issue isn't treated, these complications might occur:
    * Abscess formation. An abscess is a localized collection of pus caused by an infection. Pus contains fluid, white blood cells, dead tissue and bacteria or other invaders. An abscess may require drainage and antibiotic treatment. An abscess may cause significant damage if it involves a vital organ.
    * Bloodstream infection (sepsis). A bacterial infection anywhere in your body can progress to sepsis, caused by an overwhelming infection of the bloodstream. Sepsis may result in organ failure and death. Treatment involves hospitalization and intravenous antibiotics.

    With reference to your urine tests; Leukocytes are simply white blood cells and they are often a sign of infection. Leukocyte esterase (LE) is a urine test for the presence of white blood cells and other abnormalities associated with infection. White blood cells in the urine usually indicate a urinary tract infection. The leukocyte esterase (LE) test detects esterase, an enzyme released by white blood cells. Positive test results are clinically significant. The LE test is also used to screen for gonorrhea and for amniotic fluid infections. The combination of the LE test with the urinary nitrite test provides an excellent screen for establishing the presence of a urinary tract infection (UTI). A urine sample that tests positive for both nitrite and leukocyte esterase should be cultured for pathogenic bacteria.

    Pyuria is defined as 8 or more leukocytes per cubic millimeter, this translates into 2-5 leukocytes per high power field on a slide.(microscopic evaluation). The assessment of pyuria however is imperfect. The leukocyte count on a routine urinalysis can be affected by many factors that alter the concentration of the urine. Furthermore, error may be introduced by variation in the amount of fluid that is eventually placed on the slide.
    A second test that assesses the leukocyte esterase content on a rapid dipstick test is also used to predict pyuria. This dipstick test is 94% specific with 2-4% false positives. Substitution of this test for the gold standard microscopic evaluation may prove to be cost effective, yet , other information on the microscopic evaluation may be lost. When in doubt a culture is sent.
    Now, a prominent feature of Lupus Nephritis (Kidney damage) is Interstitial leucocyte infiltration. Interstitial leucocyte infiltration in lupus nephritis, predicts deterioration of renal function. The mechanisms that underlie the accumulation of leukocytes in the interstitium of the kidney of SLE patients is not known.
    In Systemic Lupus Erythematosus (SLE), it is difficult to differentiate between exacerbation of disease and infection. C-reactive protein (CRP) has been used to differentiate between lupus flare and infection, as in SLE, CRP levels are normal, while in infection, it is elevated. SLE flares are rarely reflected by elevated C-reactive protein (CRP). CRP rises rapidly in response to infections and tissue injury, and CRP measurement is widely employed as a marker of ongoing inflammation.
    Sedimentation rate, also referred to as sed rate or erythrocyte sedimentation rate, measures the speed at which red blood cells settle to the bottom of a glass tube. The presence of certain abnormal proteins in the blood can cause red blood cells to stick together and sink to the bottom more quickly. An elevated sed rate is not specific to any one disease, but does happen often in Lupus. Other possible causes include:
    Infection, Inflammatory diseases (such as rheumatoid arthritis and lupus)
    Blood cancers (such as leukemia and lymphoma), and Cancer that has spread (metastasized).
    Elevated ESR and CRP (C-Reactive Protein) are markers of inflammation. They can be caused by a wide variety of diseases(including Lupus), and by themselves, are not diagnostic of any single disease. Your results, as Lauri mentioned, may be due more to infection and inflammation than disease activity. I don't think that you are being brushed off, based upon the fact that they are ordering tests. Unfortunately, a lot of your issues may be related to your Lupus, but I agree that they should not use your Lupus as a dumping ground. Continue to insist that the tests be run and that you be given the results and that your symptoms be treated.
    I hope that you feel better very soon. You are not alone, we are all here for you.

    Peace and Blessings
    Saysusie
    Look For The Good and Praise It!

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    Default meds.

    The hydroxychlor the Rheum. has me on, could that be the cause of all my abdominal pain. I haven't take the hydroxychlor for about 5 days now and I am starting to feel better in my stomach. I don't know if that can cause you to have stomach issues or not.

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    I was on hydroxychlor for a few days and I had such severe abdominal pain which wrapped around to my back that I had to stop taking it. I felt like I needed to go to the bathroom, throw up and pass out all at once. I also broke out in a cold sweat! It was all very horrible and painful, not to mention scary. I can't swear those symptoms were side effects from meds but it seemed likely.

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    dlrfoto,
    I have to say that it sounds exactly like me. I have been on it alot longer than that. I have been taking it since April. I have stopped taking it. I didn't notify the Rheum. yet, but I am starting to feel better without it. I still have joint pain, fatigue, and all, but I don't have that awful abdominal pain.

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    OK, ladies, Im not an expert...But if youre not going to take your Plaquenil, you really need to tell your doctor, so maybe they can prescribe something else. I know the abdominal pain has stopped, but you dont want to go into a full lupus flare either...that can be very dangerous.
    Im not trying to tell you what to do...we all respond differently to different meds - Im just saying PLEASE keep your doc notified. I would hate to see either one of you develop serious complications from this disease..
    Keep us posted and hope youre feeling better soon!
    Love Lauri
    For God has not given us a spirit of fear; but of power, love and a sound mind. 2 Timothy 1:7

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    Thanks laurid8967.
    My primary physician knows that I have stopped I talk to her today. She and I are looking into something different and even a different Rheum. I just don't feel like he hears me when I talk. I am trying to explain things to him and he is just worried about writting his notes and getting me out the door. I just don't feel like he is doing everything he can or could nor is he putting the effort or sincerity into the appt. when I go.

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    Good for you, lc -
    Unfortuanltely, there are some lousy rheumatologists out there...I dont understand it, really, why did they go into this field if they dont know anything about this stuff? At least your primary knows the deal...
    I hope you find something soon that helps your lupus and doesnt make you ill...We dont have many choices, do we? There has not been any approved new meds for lupus in 20 years according to the LFA, ALR and more...That is UNACCEPTABLE!!!
    Good luck to you, and keep us posted, OK?
    Lauri
    For God has not given us a spirit of fear; but of power, love and a sound mind. 2 Timothy 1:7

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    Default Here is what I know...

    Okay guys here is what I know. I went for an appt. with primary physician today. Also saw my labs from the ER visit that weren't back yet. My lupus isn't quite like the Rheum. thought when I saw him. My C3, C4, and ds dna are all high. I also have mesenteric adenitis. The primary dr. was irritated when I told her that the Rheum. sent me to the ER and said that my Lupus was quiet and the ER doctor tells me that she thinks it is all Lupus related. She is also upset that they didn't try to find out why I have mesenteric adenitis. She said there is a cause and they should have ruled out if it is being caused by the lupus or not. She also complemented me on the fact that I had stopped the Placquenil. Especially since stopping I don't have the awful headaches I was experiencing, the abdominal bloating and cramping, my blood sugars have actually regulated now, and my head just seems clearer. She said I am just on of those people who can't take it.
    We discussed a different Rheum. today and she is setting me up with one affiliated with Hershey Hospital if any of you live in PA. Her and I both agree that maybe with it being a teaching hospital and the younger doctors just coming in might be more insightful and willing to look into things more and give me more help and far as my lupus goes. She agrees that I need to see the new Rheum. as soon as possible so we can try and find something else to do for me to control the lupus. She is being really aggressive again, which I love because she listens. She is also sending my for an MRI of my brain and spine. She is curious about Cerebral Lupus. Just because of different symptoms and things that have been going on, put up a flag for her. She is very straight forward and persistent. I am at least in good hands with her.
    My ? is do any of you have cerebral lupus or have mesenteric adenitis? Has anyone else had problems with the placquenil?
    Thanks to all. Linda

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