Steroids and first rheumatology appointment

[Vixen77]

Hi folks

I have my first appointment with a rheumatologist on 19th October. I first have to attend on the 2nd October for bloods and investigations. My concern is this.

I’m currently fighting my billionth (ok, light exaggeration) bout of pleurisy. My GP put my on a five day course of steroids, which is due to finish today. My symptoms haven’t resolved however and I’m still getting very short of breath so I suspect she will want to continue the course.

Will this impact my bloods? I have pretty much permanent UTI symptoms alongside this. The steroids have certainly helped the pleurisy and my aches and pains have virtually gone.

What concerns me is that being on steroids might reduce the chance of anything showing in my bloods that may help to confirm what is wrong with me?

[whisperit]

Hello Vixen77

Good question! Afaik, steroids will tend to lower some of your inflammatory markers, including those that are considered in the diagnosis of autoimmune conditions. However, diagnosis is not made solely on the basis of blood markers. In a first consultation, the rheumy is likely to pay more attention to your history and to a physical examination (looking at joints etc). In any case, your rheumy should be well up to assessing your condition properly. After all, they are assessing and dealing with patients who have AI conditions and are taking steroids all the time.

Obviously, you are going to be worried, so do make sure you don't leave until that niggling doubt has been addressed directly!

Hope it goes well, and that you are feeling a whole lot better soon x

[Hidden]

I have to be honest here and say that I’ve tapered off steroids well prior to Rheumatology consultations for this reason. The first Rheumatology apt I ever had was over 7 years ago. I’d been given a steroid jab for severe joint pain six weeks earlier by my GP and this lasted longer than expected.

My rheumatologist made the decision to wait another four months before seeing me again as all my antibodies and bloods were normal and I had no joint pain. I later realised that I’d also taken my regular ibuprofen that morning. What followed were four months of roller coaster - barely able to move my fingers or wrists for pain - same for shoulders and knees. I had to have several courses of steroids just to function but I stopped everything about ten days before seeing him and by that day he saw me at my worst and I got my diagnosis with bloods supporting me.

Breathing is different to pain though - clearly you need to be able to breathe. So I think i would talk it through with your GP and decide together. Best of luck xx

[Chanpreet_Walia LUPUS UK]

Hi Vixen,

Sorry for the delay in response to your post.

Here is information on steroids and blood tests provided by Dr Chris Wincup at UCL, I had to query your question with him

"In terms of steroids and blood tests, we know that steroids can cause a raised white cell count in some cases but this should not influence a diagnosis of lupus. Anti-nuclear antibodies (ANA) and ENA blood tests can be helpful in making a diagnosis and these will not be influenced by steroid use. In some patients, complement levels are low and dsDNA antibodies can be high (in particular in active lupus). As steroids are a treatment of lupus then these tests may be normal if treatment with steroids (that may also help to improve the lupus symptoms). It is therefore important to let your doctor know that you have taken steroids recently and it can be useful to explain if this has caused any change in your symptoms."

Please let us know how you get on, wishing you all the best.