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Lupus

Should I be tested for lupus?

07/02/2002

Question:

I am a 22 year old woman and have had 3 first-trimester miscarriages now. Recently, I started seeing a reproductive endocrinologist who ran some tests and told me I had lupus anticoagulant antibodies and an abnormal PTT result. I asked him if I should have an ANA test too to check for lupus and he said the odds were low and that I shouldn`t bother.

However, after reading a little about the symptoms...I am worried. I do get mild red splotches on my arms after I`ve been outside (although nothing you`d notice unless looking), and I do have bouts of carpal tunnel-like hand/wrist pain (although it lessens with a little massage). In addition, I also have unexplained episodes of what my doctor called "gross hematuria" that started shortly after my first miscarriage...but I was told not to worry about it.

Should I insist on being tested further to see if I have lupus, or am I just being a hypochondriac?

Answer:

Your Doctor is probably correct that you do not `fulfill the criteria` for having lupus. At the present state of our knowledge, lupus is diagnosed by a constellation of symptoms, signs and tests. Since you do not seem to have symptoms consistent with lupus and your Doctor probably did not find any signs of disease, a positive test may not necessarily mean any thing. However, if your Doctor already made the diagnosis of `Lupus anticoagulant syndrome`, it is important to perform: Routine urine tests for protein and red cells at least once every 6-12 months and an ANA test once at this stage as a baseline. If positive in high titers, then a careful history and physical exam should be performed at your follow up visits.

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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