Welcome to the site. It sounds like you have found a much better rheumatologist this time around. Diagnosing autoimmune diseases certainly can be quite complicated, huh?
You do have some of the symptoms of lupus, and some supporting bloodwork (ANA high positive and low c4). It appears as if clotting issues are not the reason for your miscarriages although those antibodies can come and go so it may be worth repeating again sometime in the future. I hope the doctor tested your urine as well if there is suspicion of lupus - even though only 50% of SLE patients have kidney problems.
Your CBC must have been normal?
If the Medrol pack helps, or a diagnosis like UCTD or SLE is given, then I would ask your doctor about starting Plaquenil as that is the 1st choice of medical therapy for either diagnostic label. It is a very safe medication and helps many people, all with very few to no side effects.
Have you had the Vitamin D level retested? Or treated? Getting those levels back up to normal can help reduce symptoms of joint pain too.
You are long overdue for a diagnosis and effective treatment! Hopefully you'll get both soon...
PS That citrulline AB is a new one to me, but with some quick Googling it appears to be relevant to RA more than anything else. What I saw mentioned 20 or higher as being positive. But... all labs are different so you will want to find out the reference range for the lab you used and go by that. here is the link that describes reference ranges for that blood test
http://www.medicine.uiowa.edu/Path_Handbook/handbook/test2250.html
You do have some of the symptoms of lupus, and some supporting bloodwork (ANA high positive and low c4). It appears as if clotting issues are not the reason for your miscarriages although those antibodies can come and go so it may be worth repeating again sometime in the future. I hope the doctor tested your urine as well if there is suspicion of lupus - even though only 50% of SLE patients have kidney problems.
Your CBC must have been normal?
If the Medrol pack helps, or a diagnosis like UCTD or SLE is given, then I would ask your doctor about starting Plaquenil as that is the 1st choice of medical therapy for either diagnostic label. It is a very safe medication and helps many people, all with very few to no side effects.
Have you had the Vitamin D level retested? Or treated? Getting those levels back up to normal can help reduce symptoms of joint pain too.
You are long overdue for a diagnosis and effective treatment! Hopefully you'll get both soon...
PS That citrulline AB is a new one to me, but with some quick Googling it appears to be relevant to RA more than anything else. What I saw mentioned 20 or higher as being positive. But... all labs are different so you will want to find out the reference range for the lab you used and go by that. here is the link that describes reference ranges for that blood test
http://www.medicine.uiowa.edu/Path_Handbook/handbook/test2250.html
