Top
20
Doctor insights on: Can A Rheumatologist Diagnose Lupus

Share
1

1
Just out of curiosity, how often do rheumatologists come across a new patient they diagnose with lupus? Is it rarely? A couple times/year on average?

Just out of curiosity, how often do rheumatologists come across a new patient they diagnose with lupus? Is it rarely? A couple times/year on average?

Room For More Rheum: Here's the set-up, you do the math: on average, about 5 cases per 100, 000 adult population in the U.S. get diagnosed with Lupus each year. There are about 250 million adults and 5000 rheumatologists in the U.S. And the answer is: a)3 b)30 c)300 d)3000 e)all f)none If you calculate (or guess) right, you win an all expenses paid trip to your favorite rheumatologist for any tests you'd like taken

2

2
Just diagnosed with lupus. Seeing rheumatologist soon. What are some good questions to ask? Does this mean I might end up in a wheelchair?

Many: As lupus is a multisystem disease many organs can be affected and your questions should be geared to this. Overall your concerns should go to short term and longer term prognosis based on current findings and what your treatment options are. You always want to use the least amount of medication that is effective.

3

3
How often should one with stable lupus and secondary sjogrens with no organ involvement see their rheumatologist?

3-4 months: This depends on the prior history of your disease, current medications, and current symptoms. Some mecications require more frequent monitoring. Prior problems may require a closer watch. In general 3-4 months if your only medication is plaquenil (hydroxychloroquine) and you are stable.

4

4
My rheumatologist diagnosed with lupus/sjogrens overlap. Does that mean my symptoms don't fit into one disease category perfectly or that I have both?

Autoimmune: Autoimmune phenomena are frequently tough to diagnose health problems. It is common to have symptoms of more than one autoimmune disease. Overlap means you have symptoms characteristic of both SLE and Sjogrens that don`t fit into one disease category as you stated above.

See 2 more doctor answers
5

5
If a dr suspects u have lupus but your lab work is borderline will a rheumatologist treat you for it to see if it helps?

Wait and see: Go to a rheumatologist. They have seen far more lupus then most doctors and they can best put together your clinical picture and your lab results. Lab tests are not the only thing that decides if you have lupus.

See 1 more doctor answer
6

6
I was recently told by my rheumatologist that my blood work is showing no lupus activity. What exactly does or can that mean?

I was recently told by my rheumatologist that my blood work is showing no lupus activity. What exactly does or can that mean?

Lupus or no lupus: If the testing was done as a screen then lab tests alone cannot eliminate lupus as a source for joint pain symptoms. If the testing was done to determine activity of a diagnosed condition then the the level of inflammatory byproducts often associated with active lupus was normal or low and may indicate response to treatment.

See 1 more doctor answer
7

7
What is borderline lupus? Rheumatologist stated I have this but what does this mean? I have a follow up scheduled but I'm so confused

Lupus IS confusing: After hearing your story and doing an exam the lab tests were ordered by your specialist. Sometimes the results are clear cut but frequently the results are conflicting or only marginally diagnostic. Your doctor will set up a diagnostic and treatment plan to make you feel better. Frequently this involves rechecking more labs in the future. This should be discussed at that scheduled follow up.

See 1 more doctor answer
8

8
Would it be appropriate to see a hematologist regarding elevated aptt and promethin levels that were done for lupus? Or should I see a rheumatologist

Would it be appropriate to see a hematologist regarding elevated aptt and promethin levels that were done for lupus? Or should I see a rheumatologist

See below: Sounds as if you may have a lupus anticoagulant based on what you are stating which can be seen in the setting of lupus. If have not had a major clotting episode or stroke, you may not need to see the hematologist but your rheumatologist or your primary can make that call.

9

9
My rheumatologist said 'if a patient has lupus then prednisone doesn't work." why is that?

Several options: Prednsione is not universally effective in lupus and the benefit may depend on the dose used. There are several other options including methotrexate, azathioprine, CellCept (mycophenolate mofetil) and a newer med, benlysta.

11

11
My dr said my blood work shows smith antibody, but rheumatologist don't think it's lupus, then what is it?

See below: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. One autoantibody is not sufficient to make a diagnosis of lupus. It would be prudent to follow the advice from the rheumatologist.

12

12
I was diagnosed by a rheumatologist as having fibromyalgia, my gp thinks it is either lupus or ms. How will they actually make a diagnosis?

I was diagnosed by a rheumatologist as having fibromyalgia, my gp thinks it is either lupus or ms. How will they actually make a diagnosis?

See below: There are no specific tests for fibromyalgia which is a condition in which there is widespread pain above and below the waist and on both sides of the body. Ms and lupus both have certain lab tests as well as other tests that can establish either of those diagnoses.

See 2 more doctor answers
14

14
Rheumatologist just started me on hydroxychloroquine 200 mg twice aday for lupus. What's ur input advise on that? Any precautions, warnings to add plz?

Rheumatologist just started me on hydroxychloroquine 200 mg twice aday for lupus. What's ur input advise on that? Any precautions, warnings to add plz?

Take the medication: Plaquenil (hydroxychloroquine) (hydroxychloroquin) is the first line therapy for sle. Unless specific problems dictate otherwise it is normally recommended for life, in every stage of sle, as mono therapy (by itself) or if needed as part of a treatment program using other medications. The main side effects are anemia (you should have a blood test periodically) and eye toxicity - you should have periodic eye exams.

15

15
My rheumatologist confirmed that I am + anti DNA antibodies but he will not confirm it as lupus, what else could it be?

Many things: 1. Positive antibodies can proceed the onset of disease. 2. It could be a false positive. 3. Low titers, especially if IgA can be seen in healthy populations. Accuracy also depends on the type of test that was used whether it was elisa or ria. No test in medicine is 100% and rheumatology tests are worse than most.

See 1 more doctor answer
17

17
ANA1:320 DNA neg CCP neg RF neg. My rheumatologist believes I have RA but testing for lupus due to symptoms but all these blood tests are confusing.?

ANA positive: A lot depends upon what is going on. With a person's signs and symptoms and the suspected disorder, ANA testing may be used along with or followed by other autoantibody tests. Lupus is only one thing that may be ANA positive. Others are sjogrens and other autoimmune. Many symptoms overlap/positive ana further testing may be ordered. Speak to your DR Its what rheumatologists know a lot about!

18

18
How often at minimal should lupus patient doing well with no issues & only on plaquenil (hydroxychloroquine) see their rheumatologist or atleast get labs?

How often at minimal should lupus patient doing well with no issues & only on plaquenil (hydroxychloroquine) see their rheumatologist or atleast get labs?

It depends: There is no definite answer. It depends on prior organ involvement, the length of time one has had the disease, how long one has been in remission and the preferences of your rheumatologist.

19

19
Neuro diagnosis MS on 7/21/14. My rheumatologist thinks I also have sarcoidosis or lupus. I had lesions biopsies today but all my blood work is neg. Possible

Neuro diagnosis MS on 7/21/14. My rheumatologist thinks I also have sarcoidosis or lupus. I had lesions biopsies today but all my blood work is neg. Possible

Comments: Sometimes, lupus, and less commonly sarcoidosis can mimic MS, but usually can easily be sorted out with blood studies or other diagnostic tests. Your skin lesions make me wonder about Lyme disease, another copycat. It is not rare to have two associated autoimmune disorders, so would agree with diligent workup. Gilenya (fingolimod) is a very good drug for MS, and may help stabilize most of this.

See 2 more doctor answers