Lupus or another Autoimmune Disease?

[Milescircus]

I’m 50 yr old female with issues, RLS, Hashimotos, Autoimmune Atrophic Chronic Gastritis, intestinal Metaplasia, Iron Deficiency Anemia w/transfusions, B12 deficiency, and now this horrible hip and joint pain. I know if you have one Autoimmune Disease you’re likely to have more. I’ve had a full work up to rule out Lupus by my PCP while awaiting a Rheumatologist.

I had multiple labs, ANA positive, dsDNA negative, Lipus Inhibitor negative , Anti CCP negative, ESR negative, RH factor negative, C3 and C4 Compliment negative, CRP negative, Cardiolipin IgA positive, IgG negative, and IgM positive. Smith Abs negative, CBC and CMP.

Can anyone by experience or knowledge help me to understand these? I mean I know what they are but how likely is a Lupus diagnosis with these results?

no immediate family history of Lupus but my moms half sister does have a diagnosis.

i suffer from excessive daytime sleepiness and fatigue to the point that I can’t function most days.

[Milescircus]

I’m sorry , positive ANA with Homogeneous pattern if that’s helpful at all.

[dg70]

I'm negative everything except had a positive dsdna, that alone got me a lupus diagnosis. I know they like positive inflammation along with symptoms usually. If you have more specific symptoms appear then see if you can get tested again. Sometimes it's a waiting game. We had a talk from a rheumatologist recently who does a lot of medical research, he reiterated there are people out there who would get a positive ana in the general population but have no autoimmune condition at all. Its about bloods along with specific symptoms. Keep a symptoms diary and pictures that may help.

[OldTed60 in reply to dg70]

With Lupus your anti dsDNA would most commonly be positive - with RA it would be anti CCP. I don’t see anti Ro or La there which in the States (where I think you’re from?) is often referred to as SSA and SSB, SS for Sjogren’s Syndrome. Some forms of inflammatory arthritis won’t show in any antibody tests eg psoriatic arthritis and Ankylosing Spondyloarthritis - I think because these are more often associated with hereditary rather than true autoimmune and are classed as auto inflammatory. So your mostly normal immunology test results and normal ESR and CRP would suggest that you may have one of the seronegative types of inflammatory arthritis or, more likely, Osteoarthritis. However in rheumatology is not a black and white science so it would be best to ask for MRI imaging of your spine to exclude a systemic/ inflammatory cause of your hip and joint pain.

Best wishes OT60

[Milescircus in reply to OldTed60]

Thank you for the info. I did not have anti Ro. LA? Lupus Antibodies? Yes. Negative. I may have left that off. I did have an MRI right hip which showed pelvis and partial left hip and I have partial tears to the Gluteus medius on both sides, complete tear of the left gluteus minimus on left side , partial thickness hamstring tears on both sides AND. A torn right labrum. No clue how this happened at all.. the MRI was ordered while waiting for the appt since I’ve had this pain for months. it did show some marrow edema and a possible strain. Mild degenerative changes in the spine. So this could maybe cause the inflammation? Would that possibly cause a positive ANA? And the cardiolipin abs that were positive have no idea. My PCP said she wondered if I had a connective tissue disorder as there was no injury/fall, etc. I will see the rheumatologist on Wednesday next week.

[OldTed60 in reply to Milescircus]

Sorry I missed cardiolipim antibodies but yes they should have included Ro and La antibodies I’d have thought - also no scleroderma or Myositis antibodies I can see but these are much rarer diseases - worth asking about though. Can’t help on torn meniscus or MSK antibodies although I do have similar pain periodically - lasts a few months then goes. Always used to show on my ESR and CRP but no longer so they blame severe osteoarthritis in lumbar and cervical spine. I have systemic sclerosis (antibody positive) and Sjogren’s (antibody negative) - also hypothyroid, Raynaud’s, severe GI dysmotility throughout inc Gastroparesis. Also HSD/ EDS - awaiting genetic testing for type.