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Feath, hello and welcome. I'm really sorry for your problems and understandable anxiety. I'm glad you're seeing your specialists on Monday.

I want to refer you to the sticky posts (permanent info posts) at the top of the thread list. (They're right above the user threads.) One contains 11 criteria for diagnosing and classifying systemic lupus (SLE). Generally (but not always), you must meet 4 or more of the 11 to be diagnosed. These don't have to be met simultaneously, btw: they may be met over time.

As for your question, Is a malar rash "required"?, I believe the answer is no. You could meet some other 4 (or more) without meeting the malar rash criterion. (There's a separate sticky on rashes.)

The other "A??" the doctor quickly mentioned *might* be APS, antiphospholipid syndrome. APS is a blood clotting syndrome seen in a fair number of lupus patients, or occasionally "standalone", I think. There's a sticky on APS, too, where you can read about symptoms, etc. Recurrent miscarriage is one of the possible symptoms of APS, I believe.

As for urinalysis, I think there are multiple reasons for cloudy urine, meaning reasons other than lupus-related kidney problems---so please don't assume too much just yet.

As for which OTHER specific autoantibodies may come back positive, I don't think there's any way of knowing until you get the results. Two are listed in the diagnostic criteria: anti-ds-DNA and anti-Sm. Yet there are a bunch of others possible, too. (For example, I had anti-Ro and anti-La, neither of which "make" the criteria list.)

Overall disease may be "subacute", meaning systemic lupus is there and needs treated, yet it isn't currently attacking major organs (like kidney, brain, heart, and lungs). In this situation, milder drugs (like Plaquenil) are prescribed. But if it's "acute", meaning major organs are under attack or certain lab values are wildly off, there are stronger drugs available to arrest damage (steroids and immune suppressants). And if APS is present, it's treated with Coumadin (a blood thinner). The bottom line is that, in this day and age, knowledge is much greater and many therapies are available. None of this is exactly good news, but on the other hand, I'm sure glad your gyno got the ball rolling, because the earlier the intervention, the better for you.

Please hang in there. I hope you post again when you can & that others chip in. You'll meet really nice people here who are always willing to talk. With my best wishes & a huge hug, Vee





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