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Please Help
Jul 19, 2008
HI, I wonder can ANYONE help intertret the tests I had done at the London Lupus clinic recently. I cannot talk to my consultant as he is in Singapore treating Lupus patients.
It said the DNA Double stranded Abs -ELISA <10.....don't know what that means?
Cardiolipin Ab IgG 7.9
Cardiolipin Ab IgM 7.8.......What does that mean
positive Schirmer's test for dry eyes
features of Polyarthralgia?
positive Oligoclonal bands in CSF
Lupus Anticoagulant-Negative
ESR 7....?
I am totally lost, with all this, and have no idea what this points to.
His letter states that he does want to see me again, but why would he when I don't have a definitive diagnosis?
Sorry to ask so many questions, but I am desperate for answers.
ANY help on this would be greatly appreciated...
Re: Please Help
Jul 20, 2008
Topsy, good morning. I know you've been seeking answers & help for a very long time, so I feel for you.

I'm sorry, but I can't guess what your results mean, as I'm just a patient, PLUS I don't know the "reference ranges" for the tests you list. That said, here are a few things I'd ask, if I were in your shoes:

1. Anti-ds-DNA is one of only two autoantibodies considered very diagnostic of SLE, so where did your result fell on the reference range? (Anti-Sm is the other.)
2. For possible SLE, in addition to anti-ds-DNA and anti-Sm, were all the *other* specific autoantibody tests done? e.g., anti-Ro, anti-La, anti-RNP, RF, antihistone, antiribosomal P, etc.
3. For possible antiphospholipid syndrome, I *think* the anticardiolipin and the lupus anticoagulant tests you cite are for this. In your shoes, I'd ask what the results mean so far, and if any further, more refined tests are indicated.
4. You could ask what "polyarthritis" means. In the US, I think the term simply means inflammation of more than 5 joints, which suggests a so-called "systemic" condition.
5. Re: oligoclonal bands, what are *all* the conditions in which these are seen? I think in the autoimmunes, there are several, including MS, SLE (lupus), Behcets, maybe vasculitis, sarcoidosis, etc. But there may also be non-autoimmune conditions that can also cause these, too...
6. Schirmer's test helps to diagnose Dx Sjogren's syndrome, but lip biopsy is considered more definitive; so is one needed? You could also ask if you were tested for anti-Ro, which is seen in upwards of 70% of people with primary Sjogren's and upwards of 30% of people with SLE.

In the UK, if you wanted to read an expert rheumie, you could look for Dr. Graham Hughes's books at your local library.

Truly, I don't think there's anything odd about your dr. asking to see you again, even though he seemingly hasn't arrived at answers. When you think about it, diagnosis always involves a narrowing of possibilities. In rheumatology, I suspect this is particularly so, since so many conditions share overlapping symptoms & test results!

I'm sorry for your delay, but I hope you can use this unexpected hiatus to prepare questions. Drop updates when you can, OK? Meanwhile, sending my very best wishes to you, Vee

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