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Thread: Not sure I'll get dx'd with lupus/labs in

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    Default Not sure I'll get dx'd with lupus/labs in

    but still not sure what it all means. I was sent off to a rheumatologist after my ANA test came back the first time, 1:320, nucleolar. 5 weeks later I was tested for a lot of things and the only thing to really come back positive is the ANA, this time 1:160. Here's the rest, with the two oddities or near oddities at the top:

    C3 - 89 (normal 90-180)**
    dRVVT (dilute Russel's Viper Venom) 41.9/sec (normal 0-42.8 ) **
    C4 - 20 (normal 9-36
    CH50 - 42 (normal 22-60)
    Anticardiolipin - all three negative
    RNP Antibodies - 31 (normal 0-99)
    Smith Antibodies - 43 (normal 0-99)
    Sjogren's Anti SS-A - 23 (normal 0-99)
    Sjogren's Anti SS-B - 13 (normal 0-99)
    Scl-70 - 38 (normal 0-99)
    Anti-dsDNA - 23 (normal 0-99)

    Anyway, on paper it doesn't really look like anything is going on. My sed rate was normal, so was my c-reactive protein, so was my urine analysis.

    My physical symptoms are hand/feet/joint pain/sensations, fatigue, periodic hair loss, IBS, migraines, pleurisy, and I also have been diagnosed with autoimmune gluten-intolerance (not Celiac).

    I have my follow up rheumatologist appointment on Aug 5 so will find out more then. Just wondering if it's possible to still have a connective tissue disease with these lab results.

    I don't know if I'm happy or sad about this. I have been having a rough time with my stomach lately and have gone in and out with joint pain. A good solid answer would be nice but I realize that's not what happens most of the time.

    Any feedback would be great...
    Stephanie

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    OK, one thing I did find that may indicate something, though weakly (my C3 was barely low), is this:

    http://www.lupus.org/education/brochures/labtests.html

    Complement
    Laboratory tests which measure complement levels in the blood may also be helpful to the physician in making a diagnosis of SLE.

    * Complement is a blood protein that destroys bacteria and also influences inflammation.
    * Complement proteins are identified by the letter "C" and a number.
    * The most common complement tests are C3, C4, and CH50.

    If the total blood complement level is low, or the C3 or C4 complement values are low and the person also has a positive ANA, some weight is added to the diagnosis of lupus. Low C3 and C4 complement levels in individuals with a positive ANA may signify the presence of active disease, especially kidney disease.
    Stephanie

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    skbird, you sound like you are in the same boat I was in when I first went to a rheumy. My ANA was only thing positive and I was not given a diagnosis then. Over then next 6 months to a year other things began to show up on my labs such as elevated sed rate, borderline rheumatoid factor, elevated liver function, and protien in my urine. In addition I have severe fatigue and joint pain and swelling and sun sensitivity. Even with all of this my doctor is treating me for lupus but hasn't given the official diagnosis.

    One thing I have discovered is that some things do not show up on your labs unless you are in a flare, so if you are having a really bad flare up you could try to get an appointment then. I have a really got PA that I work with when I have flares because I usually can't get in to see my rheumy on short notice. The PA sends all results to my rheumy. Hope this helps. It can be a very frustrating journey. It's hard to understand how you can feel so sick and have your labs come back normal. Also everything I have read about lupus is that it can take years to get a diagnosis and that symptoms can slowly develop over time. Take care and keep us updated.

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    Thanks for your response, Hippiemom2. I have been trying to decide how I feel about all of this. I'm not in bad shape but definitely feel something is going on. I hope that explaining my symptoms with my borderline results in some areas will help make sense of everything with the rheumatologist.

    What was really weird about all of this is I went to my doctor to tell him originally how well I was doing on my gluten free diet for my other health issues. I did mention that I had occasional joint pain in my hands after eating gluten but that was about it. Even my energy was much better than it was the year before. He said great, lets run these other tests to rule out any other autoimmune things. Right about then my hands started feeling weird, joint sensations, aches, stiffness, then my feet. That resulted in the first higher ANA and that's when he sent me to the rheumatologist who ran all the other tests.

    Things have actually mellowed out the last week or two except the chest pain which is worse, and then the last couple of days my hands and feet are acting up again. For example, my big toe on my right foot - every time I step down, it aches. I haven't injured it in anyway. It's something between a joint pain and a muscular pain and only hurts when I step down or put pressure on it. My finger tips have been doing similar things, making typing weird. Seems like a weird symptom.

    Anyway, we'll see what he comes up with. Thanks for the response!
    Stephanie

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