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Lupus

Could it be Lupus?

05/11/2000

Question:

Hello. I am a 42 year old Female that has had a history of boderline low pancytopenia for approximately 14 years. About 9 years ago I developed Idiopathic Gastroparesis, being treated successfully with Propulsid for the last 4 years. I cannot take Reglan, and I am allergic to Erythromycin, and IVP dye. My platelets seem to be the lowest, ranging from a low of 87 to a high of 122, with an average most of the time around 114. My bleeding times are around 12-13 minutes. I also experience mild joint pain and stiffness, and occasionally will have a day where I feel that I must be coming down with something, as I feel achy, tired and fever/chills kind of feeling, which evaporate in a day or so. I am also sensitive to cold. I am being monitored about every 3 months by an Oncologist for the blood counts. He has performed the Lupus blood work, and it has come back "inconclusive", neither yes or no. I have had 2 bone marrow biopsies, and a complete workup with tissue typing at a major cancer clinic in Seattle, all with inconclusive results. I had a complete Hysterectomy 5 years ago due to uncontrollable heavy bleeding that didn`t respond to hormone therapy. I am told that it "could be" that my symptoms are due to a faulty immune system. Could I have Lupus even though the tests are inconclusive, and if so, what does that mean for me in terms of my long-term health? I apologize for the length of this, and I appreciate very much your time and consideration. Thank You.

Answer:

Pancytopenia is one of the complications of lupus. In general it`s a low lymphocyte count or low platelet count. Also patients can have anemia which is more frequent due to the chronic disease the patient has; sometimes it is a more special type of anemia which is called `hemolytic`. I am sure you have been checked for all those. Joint pain and fatigue can also be signs of lupus, though they are not specific, may appear in more than one condition. I would have expected after 14 years for the lupus to `declare` itself clinically and that you would have more symptoms. If you want to be sure you should see a Rheumatologist who will examine you, review previous results and decide what other tests you might need for a definitive work up.

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Response by:

Yolanda   Farhey, MD Yolanda Farhey, MD
Associate Professor
College of Medicine
University of Cincinnati