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Lupus

? lupus

09/05/2001

Question:

I am a 33 year old female who started to experince extreme fatigue, joint pain, and mild fever of 99.5. At first went to my MD who performed an ANA which was 1:80. She sent me to a Rhematologist who diagnosed Fibromyalgia and als did a bunch of labs. Now my ANA is 1:160 homogenous pattern, but DNA antibodies, scleroderma antibodies, SM & RNP negative. My Hgb was 11.3 and HCT 34.3. WBC was 10.8 with absolute neutrophils of 7916. I still have joint pain, fever, dry eyes. Can you still have Lupus with all other test negative besides ANA positive?

Answer:

It is very rare to have lupus in the absence of ANA. However, ANA can be present in low titers (1:80-1:160) in several situations, including after some infections and even in completely healthy people. Since your ANA did increase a little bit, a follow up exam by a rheumatologist and a repeat ANA test in 6 months or so might help to clinch a Dx.

If you have dry eyes, your rheumatologist may like to get an eye exam performed to look for Sjogren`s syndrome. Usually, Sx of dryness in eyes are accompanied by dryness in other mucosal sites such as the mouth or genital area. Eye exam, salivary gland Bx, and tests called anti-Ro or anti-La antibodies can help in this situation, if the diagnosis of Sjogren`s syndrome is strongly suspected. Before all these tests, of course one has to rule out the use of certain drugs or other problems that can cause dry eyes.

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Response by:

Ram Raj   Singh, MD Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati