I am a 57 year old female with longstanding osteo-arthritis. I now have severe bone spur formation throughout my spine and my knees are bone on bone. For 30 years I have had "reactive airways" Any upper respiratory infection would trigger , getting easily winded and the sensation that I couldn't take a breath. Breathing test showed compromised lung function but inhalers and nebulizers didn't help at all. About two years ago, I had chronic sinus inflammation which lead to constant sinus infections and airway involvement. I started to get low grade fevers (99-100) and would start to sweet out of the clear blue. I had brain fog, fatigue and felt miserable. Blood work was all over the place with sky high markers of inflammation such as sed rate, c-reactive protein etc etc. I went to an ENT who sent me to a rheumatologist, immunologist and infectious disease doctor. Everyone agreed that I have systemic inflammation but could not pin down what the cause was. The immunologist was convinced that there was some type of auto immune/connective tissue disease that has not yet presented itself. Ten months ago, I suddenly developed a large effusion. A liter of blood was drained. The blood started to re-accumulate and this time, I was in tapenade (upper right chamber was collapsing) I had a pericardial window. The biopsy of the pericardium showed both chronic and acute inflammation. I continued to have pericarditis despite taking colchicine. I developed tachycardia, elevated blood pressure and eventually palpations. Echos and a 36 hour heart monitor were negative for heart valve involvement or arrhythmias. A cardiac MRI revealed continued pericarditis. I was recently put on a calcium channel blocker which helped with the tachycardia, elevated blood pressure and palpitations.
Two weeks ago, repeat blood work reveled elevated homogeneous ANA 1:320. A rheumatologist diagnosed me with lupus and started me on plaquinil.. When I read about Lupus, I don't have a lot of the symptoms described. I do however keep reading that late onset Lupus could have a different presentation but I have not been able to find out what the late onset presentation is. The dx surprised me. Does my history point to the possibility of lupus?
Yes, pericarditis is one of the 11 criteria for a lupus diagnosis. You need at least 4 of the 11 in order to be diagnosed with lupus.
1. Malar Rash over the cheeks
2. Discoid Rash Red raised patches
3. Photosensitivity Reaction to sunlight, resulting in the development of or increase in skin rash
4.Oral Ulcers in the nose or mouth, usually painless
5. Arthritis Non-erosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed)
6. Serositis Pleuritis or pericarditis (inflammation of the lining of the breast or lung)
7. Renal Disorder Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)
8. Neurologic Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic
9. Disorder disturbances which are known to cause such effects
Hematologic Hemolytic anemia or leukopenia (white blood count below 4,000 cells
10. Disorder per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.
11. Antinuclear Positive test for antinuclear antibodies (ANA) in the absence of drugs
I'm glad you finally got diagnosed. Now you can move forward somewhat. Praying that you will continue to progress. It is a long process for some. Most people it takes up to 10 years to receive a diagnosis.
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