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Hi. Do you have copies of your recent labs, to see *which* autoantibody tests were run? I hate it when doctors rattle off what you don't have without explaining which tests support their statements.

I imagine (but am only speculating) that the doctor was looking for Rheumatoid Arthritis and antiphospholipid syndrome (due to the lupus anticoagulant test). That said, I think there are other tests sometimes used to check for RA, like X-rays to look for characteristic "mouse bites" where bone has eroded. Actually, diagnosis of RA is generally made using 6 accepted criteria, not just RF, which may not even "have" to be positive.

For [B]antiphospholipid syndrome [/B](APS), anticardiolipin antibody and syphilis* test are usually done as well (*syphilis only because it can be false-positive in APS). FYI, there's a sticky post (permanent info post) on APS, located above the user threads, containing useful info. BTW, I believe nosebleeds can be seen in APS.

The tests you list could leave many tests for antibodies seen in [B]lupus [/B]unaccounted for (maybe they were done, maybe not), such as anti-ds-DNA, anti-Sm, anti-Ro, anti-La, anti-RNP, etc. There are a bunch.

Also unaccounted for: antibodies seen in [B]other conditions [/B]that I call "close cousins" to lupus, like MCTD (mixed connective tissue disease), Sjogren's syndrome, etc.

Also unaccounted for: [B]thryoid [/B]disorders. Those can also cause a positive ANA and many of the same symptoms as early lupus & early RA.

I too see [B]ANA of 1:640 [/B]as pretty likely to be meaningful, in the context of your symptoms.

As for the [B]red/white pattern[/B] under your skin after sun: that might be livedo reticularis, a disrupution in blood circulation. Unfortunately it doesn't help diagnose any of these conditions because it's not speciffic to any one(s). I get that reaction, too (but eventually got lupus-specific rashes, too).

Another thought---and maybe someone else here can comment on it: I think I've read that ANA can turn positive *in advance of* the more specific autoantibodies. Maybe that's what's happening here, that your dr. really DID DO all the usual specific "anti tests", but they just haven't turned positive yet. Anyway, I hope you can get lab copies & post whatever additional questions you have on the tests done, that you keep trying, and that you post more soon. Unfortunately these conditions really are hard to diagnose, so please hang tough & know you're not alone. Best wishes, Vee

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