RA/SLE overlap causing problems. My new Rheumatologist has finally accepted that desease is active, but doesn't know which.

Prior to his retirement last year my Rhuematologist of 20 years had me taper off steroids. His recommendation was to start me on a suitable Anti TNF Agent, should I deteriorate as osteopenia means steroids are no longer an option and I am already on 25 mg methatryxate, hydroxychlorine doesn't work for me and I am alerlic to Azthiaprine. At the same time, I also moved area and started with a new GP. For almost a year my symptoms have been dissmissed and I have had an uphill battle with both GP's and the new Rhuemy, but now with deformity of left wrist so severe it is likely to be in operable (according to my recent visit to the OT) I am finally being listened to. I am down for a CT scan and appointment with the Plastic Surgical Team. The concern now is that despite the obvious deformity, I aparently, do not meet the RA criteria for Rituximab. This is because my rhuematologist can find no sign of synovitis, although there is erosion of the joint on x ray, this, she tells me is not enough to be the RA and I therefore, do not meet the DAS28 score. CRP, ESR and ALP are all elevated, but she is of the opinion that this, my deformity and other issues are the result of connective tissue damage and SLE. Should the CT confirm this then she is not willing to go ahead with rituximab. I have requested I be transferred to another rhuematologist, but I wondered if anyone else might have had a similar experience as I am losing the will to live. (Figuratively) My old Rhuemy was top dollar. He recommended Anti TNF knowing I was a good cadidate for it. (His words)

[misty14]

Hi Peacedove

I am so sorry to read of your Lupus overlap problems and new Rheumy trouble too!. Osteopenia shouldn't rule out steroids if they're managed properly. I have osteopenia and still take them with daily calcium and vitamin b tablet and I also have a bone strengthening infusion every 18 months. I just wanted to give you some hope. Good luck with getting a new Rheumy, losing trusted Consultants thru retirement is hard, I've been thru similar. X

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Unfortunately, my calcium has been raised causing chronic consipation. I am under a gastroenterolist as I have had severe bouts of diverticulitis, again since coming off steroids. It's helpful to know about the bone strengthening infusions though. My OT has recommended a good consultant and I'm sure I will get sorted out in the end. I very much appreciate your encouragement, thankyou. Xx