Dr. Srinivasa C.
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 36-year-old mother and a veterinarian. I was recently diagnosed with lupus by a rheumatologist. The only abnormality in my blood work was elevated SSA and dsDNA autoantibodies with a speckled pattern. My CBC, UA, and biochemical panel were normal. My symptoms included severe brain fog, fatigue, dizziness, pain in the neck, shoulders, lower back, and hips, excessive thirst, and poor sleep. I am also positive for HLA B-27 antigen. My lupus anticoagulant screen was negative. The cardiology antibodies, beta-2 glycoproteins antibodies, C-reactive protein, and rheumatoid factors were negative. Previously, I had a polyclonal increase in gamma globulins with no monoclonal protein seen. The X-rays of the spine, chest, and hips are normal. I do not get any rash from the sun or any oral ulcers. I do not have dry eyes or a dry mouth. My question is whether I have fibromyalgia or lupus. I saw an article that said some people with fibromyalgia can have elevated autoantibodies. Another question is can I have fibromyalgia and early signs of lupus? I am currently taking one Tramadol twice a day and two 200 mg Motrin one to two times a day for pain. I was on Plaquenil twice a day for six weeks, but it did not help with any of my symptoms. I am currently taking one every other day as it will prevent it from attacking my internal organs lupus, etc. Also, are there any other treatments you would recommend? I am living a healthy lifestyle and taking vitamins.
Hi,
Welcome to icliniq.com.
As you do not have any clinical symptoms of lupus, except positive antibodies, we do not label you as having lupus. There is a criteria for lupus called SLICC criteria (Systemic Lupus International Collaborating Clinics). It is probably a fibromyalgia-like illness only, but do watch for symptoms of lupus. Continue Plaquenil (Hydroxychloroquine) to prevent internal organ involvement. If there is clear-cut evidence of arthritis, then the drug will help, but not in fibromyalgia-like illness.
Thank you.
The Probable causes
Patient's Query
Hello doctor,
So, should I continue the Plaquenil one tablet every other day for the long term? Should I check my blood work chemistry and CBC every six months?
Hi,
Welcome back to icliniq.com.
Yes, you should continue taking Plaquenil. If there are no symptoms of internal organ involvement for one year, then you can stop after consulting with your doctor.
Thank you.
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Rheumatology
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