One word. Insane..who is this doctor and does he have a certificate to practice Rheumatology or is this your primary doctor who diagnosed her. Maybe he feels he can't do anything but he should have referred her to a Rheumatologist.
Did he explain why the diagnose for SLE...meeting the ACR criteria for diagnose...
American College of Rheumatology criteria for a lupus diagnosis
The American College of Rheumatology (ACR) has developed clinical and laboratory criteria to help physicians diagnose and classify lupus. If you have four of the 11 criteria at one time or individually over time, you probably have lupus. Your doctor may also consider the diagnosis of lupus even if you have fewer than four of these signs and symptoms. The criteria identified by the ACR include:
- Face rash, which doctors call a malar rash, that is butterfly shaped and covers the bridge of the nose and spreads across the cheeks
- Scaly rash, called a discoid rash, which appears as raised, scaly patches
- Sun-related rash, which appears after exposure to sunlight
- Mouth sores, which are usually painless
- Joint pain and swelling that occurs in two or more joints
- Swelling of the linings around the lungs or the heart
- Kidney disease
- A neurological disorder, such as seizures or psychosis
- Low blood counts, such as low red blood count, low platelet count (thrombocytopenia), or a low white cell count (leukopenia)
- Positive anti-nuclear antibody tests, which indicate that you may have an autoimmune disease
- Other positive blood tests that may indicate an autoimmune disease, such as a positive double-stranded anti-DNA test, positive anti-Sm test, positive anti-phospholipid antibody test or false-positive syphilis test
Your doctor may order blood and urine tests to determine your diagnosis, including:
- Complete blood count. This test measures the number of red blood cells, white blood cells and platelets as well as the amount of hemoglobin, a protein in red blood cells. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood cell or platelet count may occur in lupus as well.
- Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease, such as lupus. The sedimentation rate isn't specific for any one disease, but it may be elevated if you have lupus, another inflammatory condition or an infection.
- Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning. Lupus can affect these organs.
- Urinalysis. An examination of a sample of your urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys.
- Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies — produced by your immune system — indicates a stimulated immune system, which is common in lupus and other autoimmune diseases. A positive ANA doesn't always mean that you have lupus, however. ANA levels can be elevated if you have an infection or if you're taking certain medications. If you test positive for ANA, your doctor may advise more-specific antibody testing and refer you to a rheumatologist, a doctor who specializes in musculoskeletal and autoimmune disorders such as arthritis or lupus.
- Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs. It may also show an enlarged heart as a result of a buildup of fluid within the pericardium (pericardial effusion).
- Electrocardiogram (ECG). This test measures the pattern of electrical impulses generated in your heart. It can help identify irregular rhythms or damage.
- Syphilis test. A false-positive result on a syphilis test can indicate anti-phospholipid antibodies in your blood, another indication of lupus.The presence of anti-phospholipid antibodies has been associated with an increased risk of blood clots, strokes and recurrent miscarriages.
Did he rule out other diseases that mimick SLE? Rheumatoid Artritis? Sjogren's? Fibromyalgia?
Did he rule in, rule out what type of vasculitis it is? Did he prescribed steroids for vasculitis? Any prescription for Plaquenil....that is usually the first line of defense for Lupus. Not even any NSAIDS?
The questions above are the things you need to be asking the doctor.
The signs and symptoms of vasculitis resemble those of many conditions, which can make a definite diagnosis difficult.
- Blood tests. If your doctor suspects vasculitis, he or she may order a blood test that checks your erythrocyte sedimentation rate — commonly referred to as the sed rate. This test measures how quickly red blood cells fall to the bottom of a tube of blood. Red cells that drop rapidly may indicate inflammation in your body.
You also may have a test that measures C-reactive protein (CRP), a substance produced by your liver in response to inflammation.
Your doctor may also check the number of red blood cells for anemia and platelets (thrombocytes) in your blood. Platelets are colorless blood cells that help stop blood loss when you're injured. Some types of vasculitis result in an unusually high or low number of these cells.
Your doctor may also check to see if you have a high white blood cell count, which can signify an infection or inflammation.
In addition, your doctor may check your blood for anti-neutrophil cytoplasmic antibodies (ANCAs) and other antibodies, such as rheumatoid factor (RF) and antinuclear antibody (ANA). ANCA can indicate a diagnosis of Wegener's granulomatosis or microscopic polyangiitis. RF and ANA elevations can be indications of an associated rheumatoid arthritis or connective tissue disease.
- Imaging studies. Your doctor may be able to determine whether larger arteries, such as the aorta and its branches, are involved through the use of noninvasive imaging techniques. These include ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI).
In some cases, though, you may need a more invasive X-ray test called an angiogram. During this procedure, a catheter, resembling a thin straw, is inserted into a large artery or vein. A special dye (contrast medium) is then injected into the catheter, and X-rays are taken as the dye fills these arteries or veins. The outlines of your blood vessels are visible on the resulting X-rays.
- Biopsy. Although blood tests and imaging studies can provide your doctor with useful information, one of the best ways to confirm a diagnosis of vasculitis is by taking a small sample (biopsy) of the affected blood vessel. The procedure is performed on an outpatient basis under local anesthesia, usually with very little discomfort or scarring.
The sample is examined for signs of inflammation under a microscope in a laboratory. If there is evidence of scarring, it implies that the condition has been chronic, or long-standing. Treatment may not be as effective in these cases, because the damage has been done and may not be reversible.
- Urine test. This test may detect abnormalities, such as red blood cells and increased amounts of protein, in your urine that often indicate a medical problem. If the kidneys are involved, your prognosis tends to be poorer.
Vasculitits does not equate to SLE...
He should atleast rule out other diseases and treat her symptoms..
The four basic rules when seeking a diagnose...
1. Bring support to your appointments because it is hard to stay focused with all the information.
2. Have a health advocate who will fight for you and not just have empathy.
3. Get a second opinion.
4. Become an expert on you illness.
Keep looking for wellness...hugs,
Last edited by Oluwa; 03-17-2009 at 07:00 PM.
I have Lupus. So *^#@! what.