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Hashimoto Thyroiditis and Lupus (SLE)
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Hashimoto Thyroiditis and Lupus (SLE)

Hi! I am a 28 years woman. I have a medical history with the following diseases: Hashimoto Thyroiditis,Hypothyroidism, angiodema, osteopenia, osteosporosis, scoliosis, lordosis, degenerative disk disease (with an herniated disk at L5 S1) and allergy. I have been receiving treatment for my thyroid probles since 18 years ago. Recently, I am having heavy pain in my joints, hands, ankles, arms and in all my bones. That pain is differnt from a normal pain, because is very heavy and intense. The reumatolgist sent me t the laboratory for an ANA test. The first test performed had the follwowing result: ANA,  IFA Homogeneous Patter 1:80, the second one had the following: ANA, IFA Homogeneous Patter > 1:1280 abnormal. With the second result the doctor sent me to laboratory again for a Analizer Lupus Panel Test. The results are the following:

Complement Component C3   112.53
Complement Component C4   14.00
Antinuclear Antibodies   Positive, Pattern Nucleolar, Titer 1:40
Anti DA   Negative
Anti J01   5.90 Negative
Anti ENA Antibodies
   Anti SM AB (EIA) 5.50   Negative
   Anti SM/RNP AB (EIA)   6.70   Negative

Anti S Jgren's Antibodies  
   Anti RO SSA AB (EIA)   3.90  Negative
   ANTI LA SSA AB (EIA) 4.10   Negative
  
Anti Mitochondrial Antibodies   Negative
Anti Gastric Parietal Cell AB   Negative
Anti Smooth Muscle Antibodies   Negative
Scleroderma  70 (EIA)   4.80  Negative
Microsomal Antibodies (TPO) 627.90 Positive
Rheumatoid Factor- IgM (EIA) 4.7 Negative
Thyroglobulin Antibodies  >1000 Positive

In addition, a bone scan was performed and the results are:
1- Mild incresed radiotracer uptake in the left ankle and tarsal region of the right foot area suggestive of imflammatory changes could also be seen with trauma.

I want to know is I have Lupus or other autoinmmune disease in addition to Hashimioto Thyroiditis.

I will appreciate your help.

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97953_tn?1193367871
You have hashimoto's based on the history and antibodies.  No definite other autoimmune disease but would discuss these results with a rheumatologist.
12 Comments
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Avatar_f_tn
I went to the reumatology doctor and he said the problem I have is relation with the Hashimoto Thyroiditis and that is why my ANA Tests results are high and positive. He prescribed me Cymbalta 30 mg, but I didn’t take this medicine because I read in the internet about the secundary effects.

Last week, I went to other reumathologist for a second medical opinion and he said I have SLE (Sistemic Lupus Eritematosus). He take under consideration than I had a high ANA test result (>1:1280 abnormal) and my symptoms of: heavy joint pain, the pain increase when I am exposed to sun, fatigue, and others. He said since my firts ANA test there was a sign I have lupus. Now, I am taking Limbrel 500 mg every 12 hours. Than is a natural medicine with no side effect. My pain decreased in intensity, but I continue having pain. That doctor refered me to an oftalmologist to chech my retinal, with the purpose to know if in future I could take Plaquenil.

In other side, I continue to be very confused I want to know if I really have lupus, because there are some doctors that said I don't have it and other said yes. The last one said I have lupus in low intensity.

Other doctors said that only the reumatologist can diagnose SLE. My endocrinology said that the ANA result of >1:1280 was not related to my thyroid condition, because at that moment my thyroid was under control.

I am very confused and want to know if I have or not SLE.

Best regards!!!
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97953_tn?1193367871
a slightly high ANA (ie 1:40 to 1:80) can be seen in Hashi.  But the >1:1280 you mention would not likely be due to Hashi.  If it is SLE then the ANA usually stays high -- again, would defer to the rheumatologist on the diagnosis.
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Avatar_f_tn
Thanks for the information. This week I have another appoinment with my endocrinologist to discuss my thyroid exams and the ANA.
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Avatar_f_tn
What can be the reason to have an ANA test result of >1:1280 abnormal homogeneous pattern? I had been making an extensive reasearch on internet and I found that lupus can have flares and ANA can vary. Also, there are 11 criteria reumathologists use, if 4 are met then they can diagnosed lupus. I continue very confused. I would appreciated your help in this matter.
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Avatar_f_tn
Didn't your dr check your vitamin d levels? They definitely should! That could be causing the joint/muscle pain and intolerance to the sun.
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Avatar_f_tn
Yes, I already checked my vitamin D levels and they are ok. I checked it last year as part of my check ups for  my osteoporosis medical condition.
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Avatar_f_tn
Today I went to my Endocrinologist and he told me that I have positive lupus test (ANA >1:1280) and maybe my condition at this moment is not active, but I must go to another rheumatologist to obtain a third opinion and determine if is necessary to start a medicine treatment to prevent future organs damages. I continue very confused about this.
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Avatar_n_tn
I have hasimoto's and fibro. six months ago started getting red patches on my skin. Thought this was fungus since have had a terrible time with yeast for two years. Went to derm dr. and biopsy showed skin changes consistent with lupus. Is a positive skin biopsy a definite way to diagnose lupus or must you have additional test to come back positive?
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Avatar_n_tn
I was diagnosed with SLE 14 years ago.  It is my understanding that ANA can be elevated for many other reasons than SLE and is used as a screening test to see if you should have more lab work done.  The DEFINITIVE test for SLE is anti-double stranded DNA.  If yours is negative, Hashimotos could be the answer.  I had terrible chronic pain in both arms and various muscle aches and pain while I was on Synthroid for Hashi.  My Dr. just increased the dosage, after I had a new thyroid panel done as he feels this pain is due to low thyroid rather than SLE.  Fibromyalgia may also be a factor.  I have been doing well these many years by using alternative health care along with seeing my medical Dr.  Things like taking fish oil (Omega 3), cucurmin and bromelin ( anti-inflammatory herbs), daily meditation and visualization have been extremely helpful.  It is very disheartening to have a chronic illness, especially an "invisible" one, but keep educated on new developments and most of all, take really good care of yourself and allow yourself to take time just for you and do your favorite things without guilt.  Stress can really bring on symptoms...we can"t always control what life sends our way, but we CAN control how we react and our attitude!  My best to you.
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Avatar_f_tn
Thanks for your information.
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740910_tn?1233688003
I am having tests at the moment - i too have hashimoto's and have just had a positive ANA test. I suffer from left sided numbness,face arm hand and sometimes leg.....had MRI scan and awaiting result..Neuro specialist wants me to repeat ANA test...i too am confused as my syptoms (symptoms) seem to be a mystery...some days my knees hurt i can hardly walk up steps.....
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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