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HI,

Nice to meet you and what a thoughtful sibling you are:blush:.

You've obviously done your research and read quite a bit. I have to say your suspicions do seem warranted. Just looking at the ARC criteria alone your sister has more than 4 - ANA, Siezures, Low platelets, Antiphospholipid antibodies, mouth ulcers....

Smooth muscle antibodies are sometimes assiciated with autoimmune hepatitis, so this also needs investigating and including/excluding as a diagnosis possibility.

Yes, her rheumatologist should be thinking about the possibility of lupus. Is her familliar with autoimmune diseases? Can your sister or someone (maybe you?) tactfully bring this up with him/her? Maybe it has been considered but not discussed with your sister (after all the right bloods were done). Try to find out why nothing further has been done. Some rheumatologists are more expert in lupus management than others. If her's is not up to speed, your sister needs to seek someone else.

Where does she live?

Diagnosing lupus is typically a slow and frustrating journey, but having its possibility considered is half the battle. Do encourage her to push for it. The right treatment could have a very significant positive impact on her wellbeing.

Keep us updated?

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