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Q. Is lupus causing all my symptoms?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 28, 2017 and last reviewed on: Sep 03, 2021

Hi doctor,

I am a 44 year old female, and I have been diagnosed with rheumatoid arthritis, systemic lupus, and Sjogren's syndrome, with symptoms dating back to as young as six years old. I have also been diagnosed with pulmonary hypertension, thyroiditis, Raynaud disease, right-sided heart enlargement, bronchiectasis, and a history of pneumonia. For about twelve years, I have had kidney pain that was mistaken for gallbladder disease, gastritis, etc., this past year, protein was found in my urine twice. Recently, I have been experiencing shortness of breath and wheezing. For most of my life, I was told that I had asthma and treated accordingly. Now, however, the asthma medications (Dulera and Ventolin) are not working. I also have a nebulizer, which is of little help, as well. I am under the care of a pulmonologist who is reticent to believe that I am indeed an asthmatic; so, now I am confused, breathless, and a little scared. Is this lupus doing this? I have been experiencing widespread inflammation, malar rashes, and a weight gain of approximately fifteen pounds over the past week. I have some personal problems, and the stress and fear just sank into me like poison. I could feel myself grow weak in the hours that followed. Before this, I was feeling pretty good. I am taking Enbrel and Plaquenil, both of which have been about as effective as sugar pills lately (although the Enbrel does give me a little bit more energy). My vision has also been worsening. My rheumatologist is almost a hundred miles away and nearly impossible to get an appointment. My primary care doctor is telling me to try harder to see the specialists. I am lost, and I do not know what to do. Any advice would be appreciated. 

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Hi,

Welcome to icliniq.com.

  • The diagnosis of asthma is doubtful as pulmonary issues are seen in conditions you are already suffering from like SLE (systemic lupus erythematosus) and rheumatoid arthritis. Basically, the right term for you is MCTD (mixed connective tissue disease), which are associated with pulmonary fibrosis and restrictive lung disease.
  • Now ideally you should go for a CT chest and pulmonary function test, and we shall evaluate the cause behind this. However, the general treatment remains the same with local steroid inhalers and bronchodilators, I suggest Formoterol and Budesonide combination.
  • Adding up a diuretic will help you with reducing the congestion and shedding down water retention induced weight gain. If you have a medical insurance or if you can afford it, I suggest you go for treatment with Rituximab. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

I hope it helps you.

For further queries consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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