[Sprocket]

Anyone have lupus and spondyloarthritis (such as psoriatic arthritis) as part of your differential diagnosis when you were trying to identify what was wrong? If so, what finally tipped the scales to allow your rheumatologist to make the diagnosis? There are many common features such as joint pain, fevers, and fatigue. My rheumy is very thorough but she seems to be focusing on my joint pain as being more like psoriatic arthritis because it is non-symmetrical. I am fearful of an incorrect diagnosis because I don't have psoriasis (90% of those with psoriatic arthritis do) and I am sun sensitive and develop a rash on my face, although not a classic malar pattern it responded perfectly to prednisone.

Just a bit of background as this is my first post. I started a year ago with night sweats and fatigue. Then joint pain, migraine, rash (worse in the sun) and fever joined the party! Also have livedo reticularis and tietze syndrome. Hardly ever sick my whole life and in the last year I have visited the following dr for these symptoms: obgyn, endocrinologist, rheumatologist, dermatologist, infectious disease dr, and a hematologist.

Only positive testing was ANA of 1:160 hgeneous and speckled. Also a low eGFR and can no longer take NSAIDS (Eventhough I have never been one to take them) Negative MRI for sacroilitis. Negative on hand, wrist, and sternoclavical X-rays for erosions.

Just started methotrexate for joint pain with swellings.

Anyone with a similar situation and symptoms and what was it that identified it as lupus?

Thanks so much!

 

[debatat]

You could see a dermatologist for your rash, they can do a biopsy if ncessary to determine the cause. A few of our members have been diagnosed this way. Although I see you have although been to a dermy. What did they say about your rash?

 

[Sprocket]

The dermatologist I saw couldn't seem to differentiate between rosacea and something autoimmune related. He was reluctant to biopsy and gave me a trial of 20mg prednisone. Which worked great for all symptoms. I tapered off because I felt like it was masking my symptoms and delaying a diagnosis and all symptoms returned.

I see a new dermatologist on July 20th that specializes in autoimmune related problems. Hope that she will biopsy!

Could it still be lupus if joint pain is asymmetrical?

Thank you for your response. That makes me feel I am on the right track to pursue with new dermy!

 

[mark176]

Hi

I dont have lupus, but some type of autoimmune. Fir me the pain would be in one area for a while and then move. However, steroids helped but didnt solve my problem Antimalarial was far more helpful

 

[Sprocket]

I have heard of pain migrating like that with "lupus-like" issues. I'm glad the antimalarial has worked for you. With my sun sensitivity I wonder if that would help me as well. Hopefully the new dermy will give me some direction. When I am feeling good the pain is a nagging soreness in those 5-7 joints affected. When I am feeling bad and running a fever I feel like everything is affected and my whole body is 20 years older! I'm glad to have started some treatment with the methotrexate (just started Friday) for the joints because prednisone is not something easy to be on long term. My mom had to be on high doses for a long period of time due to sarcoidosis.

 

[mark176]

Hi

Mepracrine is much better for sun sensitivity. I was on it a while as a plaquenil/mepracrine combo. However, i think a lot of members use high skin factor sun cream.

Kind regards
Mark

 

[debatat]

Sprocket, if it was roseacea then steroids would have made it worse hence the steroid trial. Also lupus joint pain and swelling can be in any combination it generally does its own thing, it is known as the great mimicker which is why it is so hard to diagnose.

 

[Sprocket]

Thanks debatat, that makes sense. I don't think the first dermatologist deals with a lot of autoimmune rashes and along with the rheumatologist recommended I see this new dermy who does. I will be sure to tell her about the success of the prednisone. Thanks for all the info everyone! I'll post back and let ya'll know what happens!

 

[Sprocket]

Just thought I would give an update as I finally received my diagnosis of Rheumatoid Arthritis a week ago as my RF factor tested positive. The rash was biopsied twice and both came back as rosacea which is heat sensitive hence the worsening in the sun. I have since learned that there is a rash associated with RA maybe just inflammation of the blood vessels and that is why the prednisone helped?? I will also say that although I have stiffness in many joints, my joint pain and swellings are still not symmetrical as most RA is which is something to consider if you currently undiagnosed. I am currently on methotrexate and plaquenil and might be back from time to time on this forum as the medications are all so similar for these diseases. And for those still searching for answers I wish you the best of luck!

 

[debatat]

I am so glad that you have finally got a correct diagnosis. That is interesting about about the rash. We are happy to have you on the forum, as the diseases are so similar and living with them involves the same stresses.

Wishing you all the best.