Lupus? Rash on chest/neck - ? sign - Mouth Ulcers please describe for me

[goodlordyIjusturned40]

HI there all ~

I have a postive ANA and consitantly low Vit D with some CT findings of enlarged liver and spleen. My symptoms are fatigue, joint aches, headaches, loss of energy, flu like syndrome with swollen glands, thyroid nodule, neuro symptoms, episodic periods of the aove with some other symptoms with periodic heart palpitations.

I was referred to a Rheumatologist due to the above. He began to state he thought most of the symptoms could be attributed to my Thyroid issue. I was recently diagnosed with a thyroid nodule and while there, the Endo stated with the new TSH values, my TSH of 3.5 was considered hypothyroid so she started me on Synthroid.

My sister has Hashimotos - but she said my thyoid look smooth other than the nodule, so she did not think Hashi's even with the positive ANA.

I advised the above to the Rheumy who then proceeded with the exam. While on the table he said he noticed a rash on my chest, neck and back and asked if I always had that - I said I didnt even notice it, but yes I get a rash on my chest that comes and goes - but no butterfly rash on cheeks and I like the sun.

He then said that the rash was a ??? sign which actually did point to Lupus. I cannot remember what he called it and want to look it up. Does anyone know what sign he is referring too???

He then asked if I ever got ulcers in my mouth and I said, actually YES - I had. Like 3 times since January I had non painful ulcers in my mouth and I didnt even know I had them until I ate, then I could feel them on my gums which is what brought me to the mirror to find them. He asked if they were like cancer sores - and I said no they were just weird ulcerations at my gum line that did not hurt,,,, just annoying when I ate. But it onlyhas happened 3 x in the last 8 months and they only last about a week.

He then kind of perked up again and said that too could be a point to Lupus.... so he wrote for a bunch of labs and I have a follow up in 2 weeks.

Can anyone tell me about these mouth ulcers and the rash.... Is 3 times a legit sign of Lupus. Can you describe yours?

Thank you so much for the help. I want to look up that "Sign" he was referring to with regard to my rash and I want to have some personal experiences with regard to the mouth ulcers so I am prepared for my next appointment.

Thank you !!

Wishing you all well

[JenB12]

.

[JenB12]

Hi there,

I have Hashimoto's, and I can tell you from personal experience that it can cause many of the symptoms that you describe above. Did they test you for any thyroid anti-bodies? TPOab, or TGab? That way you can get a clear cut answer on the hashimotos. Anyways my guess is in 6 weeks of being on synthroid you should know if it is just an issue with your thyroid, or if there is something else going on too! I have not had joint pain in association with my thyroid problems but Ive spoken to a couple of people who have. Low thyroid function will mess with your metabolic processes and can lead to muscle aches, weakness, fatigue...etc. 3.5 TSH is not that high but mine was only 4.56 when i was dxed and i felt miserable, could barely get out of bed. So i;m not so sure if the TSH level is as much an indicator as some doctors believe. I've got a brother who has Hashimotos too and his TSH got up to 100+ !!!! Anywyas you will hopefully know so much more in 2 weeks when you have your lab results and follow up. I know it's difficult to wait that long... i'm in the same boat!!!!!

Karajo,

Two really quick questions that maybe you can answer for me. 1. How do they test for serositis??? is there a way for them to suspect it w/o chest x-ray? and 2. Do you know if "Epithelial Squamous Cells" and white and red blood cells in urine count as "cellular casts"? I just am not sure as to the significance of those as they were present in my last urinalysis.

[karajo]

one more thing, lupus can attack any organ.  Thus it can affect the liver and speen.  There are also other autoimmune diseases that can affect the spleen, but I'm not aware of any that affect the liver.  

[karajo]

To start out, most all of us are not doctors.  So all we have is an educated guess and our opinions.  First of all, Hashimoto thyroiditis sounds like a very complicated condition.  I'm not sure that joint pain is associated w/ this disorder.  Celiac disease sometimes goes along w/ Hashimoto, and (if I remember correctly) joint pain and diarrhea are associated w/ celieac.

Having a sister w/ Hashimoto, what does she think about your symptoms?

What is your ANA level and what is the pattern?  I have lupus and your sx sound like they could be lupus related.  Are you familiar w/ the sx of lupus?

There are 11 criteria for a lupus dx.  You must have at least 4 of the 11 to recieve a dx.

They are:
1. malar rash over cheeks (butterfly rash)
2. discoid rash, red raised patches
3. photosensitivity - reaction to sunlight, resulting in skin rash
4. oral and nose ulcers
5. arthritis
6. serositis - inflamation of the lining of the lung or heart
7. reanl disorder - excessive protein in urine and/or cellular casts
8. neurologic disorder - seizures, or psychosis
9. anemia or low white blood countor lymphopenia or low platelet count
10. positive ANA
11. positive anti-DNA or anti-Sm, or antiphospholipid antibody or false pos. syphilis test

Other symptoms are:
-hair falling out
-fatigue
-muscle pain and weakness
-dizziness
-poor memory
-headaches
-tingling in extremities
-diarrhea
-bloating
-weight loss
-abdominal pain
-blurred vision
-depression
-palpitations
-raynauds (where fingers turn white when cold)
-intollerance to cold
-sore throat
...to name a few

Keep in mind that fibromyalgia, CFS, MS and lymes disease also have similar symptoms.  

Let me know what you think.
God bless, Kara