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Posted by CCF Neurology LG on March 16, 1998 at 14:50:59:
In Reply to: Is it possible to have MS and Lupus? posted by Anneliese Reitz on March 16, 1998 at 13:14:28:
: I am in the process of being worked up for Multiple Sclerosis and Lupus.
The last couple years I am troubled be flare ups of joint pain and skin
rash on my face. The rash on my face will leave permanent scars. I also
am bothered by recurrent neuro problems such as numbness and tingling in
my arms and legs. I am bothered by vertigo, vision loss and coordination
problems. My primary doctor feels I have early stages MS due to the relapsing
and remission of symptoms. Is it possible to have both diseases? Or can one
mimic the other. I appreciate any input you might have.
Sincerely, Anneliese Reitz
The diagnosis of MS or SLE can pose a diagnostic dilemma. The disorders overlap clinically withe features and lab findings. Both have an autoimmune pathogenesis, are chronic disorders and respond to steriods. There is a hypothesis that they may have a common etiology, however, this has never been proven. In SLE, there may be multiple lesions in the central nervous system "white matter" that may parallel the activity of the underlying disorder or levels of the autoantibodies. Conversely, between 5 and 10 percent of patients hava ANA or anit DSDNA antibodies without any evidence of SLE. On MRI, the lesions of SLE appear similar to the plaques of MS. In both, the optic nerve, brain or spinal cord may be involved leading to a variety of symptoms based on the location of the lesions. SLE may also have clinical succession of attacks that resemble the relapsing/remitting course characteristic of MS. Pathology of the "lesions" show that in SLE the lesions represent small zone of infarct secondary to a small vessel vasculitis or embolism rather than the demyelination of MS. The joint and skin rash are typically found in SLE not MS. The overlap between the two diseases in symptoms, course, and lab is significant, I would work with your doctor to establish one diagnosis rather than two. If at any time you are interested in getting an evaluation at CCF, call 1-800-CCF-CARE.
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