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Q. I have been diagnosed with early-stage lupus. What can I expect in the future?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 13, 2020 and last reviewed on: Sep 19, 2020

Hi doctor,

I started having joint pain a year ago in the neck, shoulder, wrist, and foot. I went to see my internist who ran an ANA, and it came back positive with a 1.116. Then saw a rheumatologist who took more tests and said I tested for early-stage lupus with a 29 in the anti-DNA antibody test. C-reactive protein is slightly high, but I had a chest infection when he took the blood. I am a 51-year-old male, height about 5'1", and weight about 240 lbs. The doctor is too busy to talk to me, and I am worried about what I have read. I want to know what to expect and if this can still be something else like cancer.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome to icliniq.com.

Do not worry; we are here to help you. The large joint pains are not significant for autoimmune (abnormal immune response) diseases. I need to know if you have:

  1. Any specific small joint pains.
  2. Any eye problems like uveitis (frequent reddening or itching of eyes).
  3. Any oral ulcers or any genital ulcers.
  4. Any history of chronic sinusitis (inflammation of the sinus) or nasal polyps (benign growth in the lining of nose).
  5. Normal kidney function.

The anti-DNA antibody is a test for lupus, but it may be falsely positive. To diagnose you as lupus, we have 11 criteria that you can find on the net, and you can see. Another thing is, before commenting on anything, I would like to see all the reports so that I can give you a confirmation of your disease. Also, do tell me the medicines you are taking. I hope you have not been started on steroids yet, leading you to a chest infection.

At this time, I can assure you one thing that lupus is not cancer. It is an autoimmune disease, and we can control its progression by medications.

But we should be sure of the diagnosis before we start medications.


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Thank you doctor.

I am on Advil and Vitamin D. I had a six-day course of steroid for another issue (neck pain). I have pain in wrists, one foot, and sometimes elbows. Except for pain behind my right eye, there is no other eye problem (seems like a muscle pain). This has been on and off for years. Had hip pain that is no longer an issue. All my blood work was normal over the last two years. The only reason my doctor did an ANA is that he wanted to look into autoimmune disease. I had neck pain and two degenerated disks, which I told, causing the neck and shoulder pain, no nasal issues, and no kidney problems. I had a pelvic and stomach CT, colonoscopy, and endoscopy, which all came out normal as well.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

I have studied your reports (attachments removed to protect patient identity), and I do not find any reason to worry excessively. Your Anti-dsDNA and ANA (Antinuclear antibody test) are on the higher side, yes they can be, in lupus, and they can even be normal. I am sure your doctor must have said that you might be having lupus (early stages), but no one can label you as a patient of lupus with these tests. You do not fit entirely in the lupus criteria with the available details here. Even if you have, the good news is, your kidney functions are normal, you do not have any hematological abnormality. A lot of people may have lupus and even do not come to know about it. I do not recommend any treatment of lupus at this stage as the drugs used have a long list of side effects. However, a follow-up is required to see for the disease activity. Your other markers of inflammation in your body like ESR (Erythrocyte sedimentation rate), are normal, CRP (C-reactive protein) is slightly higher than that can occur in any infection. So, stop worrying, and do not take Prednisolone for neck pains unless indicated. I could not see any uric acid report, get it done.

Take Advil (Ibuprofen) only if need, not regularly. Continue with Vitamin D3. I hope that I have solved your query, still, if you have any questions, please ask me.


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