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lovessunshine, hi & welcome. I'm just a patient, but I hope you're seen by a rheumatologist. From reading, I believe RF and CRP can elevate in lupus and rheumatoid arthritis, maybe in other conditions, too (I'm not sure).

As for being negative for anti-ds-DNA, that's good, of course, but other autoantibodies are also possible in lupus. Only two---anti-ds-DNA and anti-Sm---are considered "specific" enough to be included in the diagnostic criteria, so think of those two as being the short list rather than a full list. You can read the criteria in the "sticky posts" (permanent info posts) at the top of the thread list right here. (As an example of this, I was positive for anti-Ro.)

In the same vein, rheumatoid arthritis has its own set of daagnostic criteria.

As for loving sunshine, have you had recurrent skin rashes? Do you notice any exacerbation of overall symptoms after sun exposure?

Hope above gives you a head start & that you post more soon. Sending my best wishes, sincerely, Vee
I had the same ANA titer, positive for SS-A, very high RF and elevated SED. My rheumatologist diagnosed me last year with Sjogren's, but I meet more than enough criteria for Lupus. I've been in a horrible flare for the past two weeks, with the joint and muscle pain so bad I can hardly walk, my hair is falling out (again...it had JUST started to grow back), and now I'm getting mouth sores. Because I didn't test positive for the specific SLE antibodies though, he won't diagnose me with Lupus. I've had pleurisy, anemia, now leukopenia, arthritis (or arthralgias? I'm not clear on the difference - but I do get joint swelling as well as REALLY bad pain), severe muscle cramps, I have Raynaud's, the high ANA, mouth ulcers, and occasionally will run a mild fever even though I feel fine.

Anyway, with an ANA that high, there's a very good possibility of connective tissue disease, but not necessarily Lupus. It could be Sjogren's or, less likely, mixed connective tissue disease or sceleroderma (I think those last two are pretty rare...?)
Hi, Sjogren's. Have you seen the diagnostic criteria in the "sticky posts" at the top of the thread list? There's an important point to be made about the several antibodies cited: anti-ds-DNA and anti-Sm are listed because they're the two considered pretty much unique to lupus.

But---and this is a huge "BUT"---others are possible in lupus, too! They're "fuzzier", in the sense that they can occur in SLE and in other conditions as well. e.g., anti-Ro (SS-A), anti-La (SS-B), RF, antihistone, anti-RNP, antiphospholipid, antiribosomal P, antierythrocyte, ANCA, antilymphocyte, antiplatelet, and antineuronal. These vary in "lupus specificity", ranging from Poor to Excellent. (They're listed in a chart in one of my hardcovers. You should browse your bookstore or local library!)

This means you can have SLE *without* anti-ds-DNA or anti-Sm, *if* you meet 4 or more criteria (generally speaking, b/c it's not a hard & fast rule).

I tested positive for anti-Ro, but my ANA was negative. This is called "Ro-lupus". It's rare, constituting only 3-5% of all cases. It's believed that in some patients, anti-Ro "blocks" ANA from showing as positive.

If someone has a positive ANA & anti-Ro, a doctor should consider Sjogren's, SLE, or both. (That's what I was told.)

I think the most accurate test for Sjogren's is a lip biopsy. (I never had one because I didn't have substantial Sjogren's-like symptoms.) To help prove or disprove lupus, I had multiple deep-punch skin biopsies done which were then subjected to immunofluorescent Alcian stain tests. If these tests "light up" in lines, that's considered very diagnostic of lupus.

So this is a roundabout way of saying that I don't think a doctor is correct to "demand" that anti-ds-DNA or anti-Sm be present, in order to consider lupus. That sounds totally presumptuous for a patient to say, I know, but my diagnosis was done by two specialists affiliated with a major teaching hospital, and they had the courtesy to correct my misunderstanding of the diagnostic criteria. They both said that many doctors don't really understand the critera, which is scary and depressing.

I hope this makes reasonable sense---it's a tricky concept to try to convey. QUESTION: are you on any meds at all? I'm so sorry you're in limbo, and I sure hope you can get out of it soon. Post more when you can, OK? Sending my best wishes, Vee

P.S. I've met only one other woman who had the same rashes I had. She had positive ANA, anti-Ro, and antiphospholipid. Like me, she bombed out untterly with local specialists and finally went to a major teaching hospital, where she was diagnosed in a matter of weeks.
[QUOTE=lovessunshine;4958121]Wow ... and wow again!
I am learning that there is a RF, but also a RA, count.
Was your count of: "243" ... a RF, or RA, count?
Cheers.[/QUOTE]

This is my rheumatoid factor. I've never heard of an RA count...? I know there's a test that's specific for rheumatoid arthritis called an anti-CCP - it's another kind of antibody. With my lab, the value had to be greater than 20 to be considered positive and mine was 16. But that test is only positive in something like less than half of people with RA (if I remember correctly).
[QUOTE=sjogrens;4958200]This is my rheumatoid factor. I've never heard of an RA count...? I know there's a test that's specific for rheumatoid arthritis called an anti-CCP - it's another kind of antibody. With my lab, the value had to be greater than 20 to be considered positive and mine was 16. But that test is only positive in something like less than half of people with RA (if I remember correctly).[/QUOTE]

Thanks. I was reading anther noticeboards where people were saying their RA count was ... I guess they were refering to the RF count. Thanks for letting me know. Cheers
Hi!! Just wanted to comment on Lupus Bloodwork. I was dx with a postive ANA 1:640 and positive SSA....I saw 3 rheumy docs...the most impressive and the one who dx me with Lupus was a grad of Johns Hopkins...she told me this blood combination is definately LUPUS (SLE)...I also had extreme fatigue/ facial rash/photosensitivity/infertility/joint pain and livido reticularis/nasal sores...basically a mess. I was dx at age 40...started feeling lousy at age 28...ugh!!!! Sounds like you may have lupus and sjogrens.... just a thought. good luck !!!! Jen in NJ





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