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Arthritis and Rheumatism

Do Elevated ANA and Sed Rate Indicate Lupus?

02/13/2008

Question:

I had shoulder surgery in August of 2007(tear, bone spurs). It is now Janurary 2008, my shoulder continues to hurt since the surgery, MRI last week indicated serious inflammation, fluid, rotator cuff completely torn. Drew fluid out, no crystals, no bacteria. Did blood work positive ANA screen, titer 1:40, elevated sed rate 41, RA screen negative and unidentified cystoplasmic staining, titer was speckled. My concern is that my mom had lupus and I am concerned that I may have it. I don't know how the rotator cuff got dissolved but I did nothing to tear it. Thank you.

Answer:

It is difficult to assess for risk of Systemic Lupus Erythematosus (SLE) or for developing SLE with the information provided. Concern for an inflammatory arthritis related to SLE would be higher if there were multiple joints involved. Rotator cuff injuries may be induced by anatomic pathology. For instance, bone spurring in the appropriate location in the shoulder region can cause tendon impingement and damage. I agree that given the outcome you described with your shoulder surgery, further investigation is needed.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University