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Thinking Lupus or not?
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Thinking Lupus or not?

HI all,  Thanks for taking time to read this and help sort through some things.  I had a Total Thyroidectomy secondary to Hashimoto's Thyroid (autoimmune) 4 years ago- had incidental diagnosis of papillary with follicar variant microcarcinoma.  Ended up with hypoPARAthyroidism as a result of surgery (low calcium/high phosphorus).  Calicum has been normalized/controlled recently and TSH is maintained.  I'm 38 yo, more recent Fatigue, hip/wrist pain and muscle pain, calf tenderness,  red/malar rash appears and disappears usually within hours (also photosensitivity), hair loss, extremely cold hands/feet (and nose), general ill feeling.  ANA titer 1:160; Nucleolar pattern; Sed Rate 27mm/hr; CPR very low.  Any thoughts on Lupus or Scleroderma (although no skin issues other than rash)?  (Sed Rate shows reference range of 1-40 however, I've read than under age 50 it should be <20.  Waiting to hear from PCP but wanted some of your "expert" opinions in the meantime.  Thanks!
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In addition....my dsDNA (2 IU) <10 is negative.  
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The Nucleolar pattern are not often seen in SLE (systemic lupus) and suggest scleroderma.  

In scleroderma the connective tissue in and around the tiny blood vessels called capilaries becomes inflamed.  As the inflammation heals, internal scarring occurs.  THis makes the tissue shrink nd become stiff.  

The symptoms are the skin and the esophagus are almost always affected.  Patches of skin become shiny and uncomfortably tight, an the esophagus stiffens.  You could also have joint pain as well.  There are usually general symptoms including a persistent slight fever, loss of appetite and weight and feeling ill.  

Your dr. may want to do some test like a barium swallow X-ray.

•Antitopoisomerase-1 or Anti-Scl-70 antibodies appear in the blood of up to 40 percent of people with diffuse systemic sclerosis.
•Anticentromere antibodies are found in the blood of as many as 90 percent of people with limited systemic sclerosis

Here's a link to Scleroderma on MedHelp
http://www.medhelp.org/medical-information/show/823/Scleroderma  and for some more technical information you can try here, too
http://arthritis.about.com/od/sclero/a/hohscleroderma_3.htm
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