Get E-Book on COVID-19

Q. I got episodes of Raynaud's in hands and on and off muscle pain. What to do?

Answered by
Dr. Kusumakar Srivastava
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 15, 2019

Hello doctor,

I am a 43-year-old female. About a year and a half ago I noticed Raynaud's in one finger. I had three episodes in two years. I have lost most of my eyebrows. Recently, I got three episodes of Raynaud's in both hands, and most fingers. I have joint pain that comes and goes in all joints. I have widespread muscle pain that comes and goes. The intensity changes. I am fatigued and just noticed that upon awakening, my fingers are a little swollen. I cannot get my ring off until about one or two hours after waking up.

I have had plenty of bloodwork ANA's, ENA, Scl 70, centromere, PM Scl, all of the scleroderma and lupus testing along with Sjogren's. ANCA, P ANCA, CPK, ESR, RF, and ds DNA tests.

The only test that was abnormal was C3 and C4 decreased and elevated anticardiolipin IgM. My WBC was also low. Since 99 percent of lupus is shown on positive ANA, what could this imply in the absence of a positive ANA?

Dr. Kusumakar Srivastava

Diabetology General Medicine Internal Medicine Rheumatology


Welcome to

I have gone through your query and what I can convey is that in most of the cases, clinical picture is that of systemic sclerosis, scleroderma, SLE (systemic lupus erythematosus) but as per the reports elevated anticardiolipin IgM and decreased complements can also be found in ITP (idiopathic thrombocytopenic purpura), rheumatic, psoriatic arthritis, primary Sjogren's syndrome and in cases of SLE who are at increased risk of vascular thrombosis, thrombocytopenia cerebral infarct and recurrent spontaneous abortion.

Was this answer helpful?


Thank you doctor,

When you say sclerosis, scleroderma, and SLE do you mean overlap of both systemic sclerosis and SLE or it may turn into one of the two? Is decreased C3 and C4 seen in systemic sclerosis? Increased anticardiolipin IgM? What is the likelihood of SLE with negative ANA?

Same question for systemic sclerosis, what is likelihood with negative ANA as well as negative Scl 70, centromere, polymerase, etc.? What is your opinion about antibiotic therapy?

Dr. Kusumakar Srivastava

Diabetology General Medicine Internal Medicine Rheumatology


Welcome back to

Thanks for asking.

1. It will be one of the two most probably SLE.

2. No very rarely as these are the features of SLE.

3. ANA negative lupus exists but is rare in adults and is usually associated with other autoantibodies (anti-RO or anti-DNA).

4. Antibodies against Scl 70 (topoisomerase 1) and centromere are specific for systemic sclerosis and are mutually exclusive.

5. Very little role of antibiotics in systemic sclerosis only if you are having bacterial overgrowth syndrome (abdominal bloating, diarrhea) then, Metronidazole, Tetracycline, Erythromycin can eradicate that. In SLE there is no role.

Was this answer helpful?


Related Questions:
My finger is swollen and I have poor blood circulation in my hands. What is the treatment?
My joint pain is affecting my academics. Please suggest a permanent cure.
I am being tested for antiphospholipid syndrome. What will the treatment be?

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Is lupus causing all my symptoms?

Query: 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 enlargeme...  Read Full »

Prevention of Joint Pain in Old Age

Article Overview: Joint pain in old age is a major concern that should not be ignored. Most of us suffer from knee pain or back pain after an age. If we follow simple measures in daily routine then most of these conditions can be prevented. Read Article

Dr. Tiwari
Orthopaedician And Traumatologist

Knee joint pain and backache especially in the lumbar region is a very common problem. Almost every one suffers from these problems in life either because of unhealthy lifestyle or some disease. In most cases, these are preventable and treatable, but due to lack of knowledge most people suffer from ...  Read Article

There is sever pain in my pinky finger on moving. Why?

Query: Hello doctor, My pinky finger on my left hand (which is my writing hand) is hurting a lot. I have to keep moving it so it will not go numb and it is going red like in the photos from my pinky down to the knuckle on the side of my hand, it feels strained or dislocated every time. I run cold water on...  Read Full »

Also Read

COVID-19 Testing
COVID-19 testing includes analyzing patient samples to determine current or past infections with SARS-CoV-2. Read the ar...  Read more»
I feel a restlessness in my legs, which decreases my sleep quality. How to get a refreshing sleep?
Hello doctor, I cannot get refreshing sleep some days in a week, and some days it is good. I also have difficulty sleep...  Read more»
I have redness in my eyes. How to stop it from getting redder?
Hello doctor,I am a 16-year-old boy. I have a problem with my eyes, and I had this problem for a very long time. I do no...  Read more»

Ask your health query to a doctor online?

Ask a Rheumatologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.