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Hdisco, I think Vee covered a lot of good info. You are not crazy! Only a few things I can add-if you can get actual copies of your test results, and care to post them here, it would be helpful. Please be sure to put reference (normal) ranges with your levels, as that can change depending on type of test done and lab. It is important to know how high the dsDNA antibodies were both times, and how high the ANA was in Dec.
Hopefully there will be a titer, like 1:320, not just a positive/negative result. Anti-dsDna is fairly specific for lupus, and anti-Smith antibody is even more so, but it is isn't positive in everyone with lupus. Nevertheless it should be run. In looking back at previous labs, have you had sed rate, CRP or complement (C3 and C4) run? These would be helpful too. Sometimes we have to insist that ALL related tests be run to uncover the cause your illness, instead of just a few here and there. I question why your rheum would dismiss a positive anti-dsDNA as negative. Another avenue that might get this diagnosis cleared up- a skin biopsy if you still have the rash or it reappears. This MUST be done with a "lupus band test" to be meaningful, and would be done by a dermatologist. Xray of your worst joints could point to RA if they show erosions, so xrays are worth doing too to get a clearer picture. Hang in there. You should not have these symptoms at 40, and you may have to push to get all the tests you need. It is worth pursuing so you get can treatment and feel better!

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