Undiagnosed

[Andrea0414]

I'm a 38 year old female. I have had an on and off again rash on my upper arms for 4-5 years. It used to get it once in awhile, have it for a week or so and then gone for months. For the last year it has been there more and more. And I have had it now for over three months. I went to my MD 2 weeks ago. He did a cbc with differential and several autoimmune test.

Some of my results:
Elevated lymphocytes
Elevated monocytes
low b12 level

Ana 1:1160 speckled
SMA 1:80

Skin biopsy probable for lupus.

My Doc thinks I have discoid lupus. Of course, I have tried to research all of my symptoms and test results. I tried to talk to him about Autoimmune Hep b/c I read that a high SMA level is seen in AIH and NOT present with Lupus.

I dont have liver problems that I know of. I have extreme fatigue. Some muscle aches expecially in my legs. Arm rash and now have it in the roof of my mouth as well.

Any input would be helpful. I go to see a Rheumatologist in February. Long time to wait for answers. I see my MD next Friday and want to ask for some liver test but he blew me off when I mentioned AIH before.
Thanks, Andrea

[tashka]

Could you, please,  explain what is SMA?

Your symptoms do sound like lupus. It often manifests with skin rash. Extreme fatigue is also very common.

With autoimmune hepatitis you should have some lab changes-elevated AST/ALT/ GGT, bilirubin. Did you have these done?  Rash is not a symptom of hepatitis.

I am sure, Rheumatologist will help you to sort it out. You say that you read that high SMA (again, don't know what it is) is not present with lupus. But remember that in medicine, nothing is absolute. Doctors see exeptions from the rules very often. And diagnosis can take some time to make. It is good that you will see a specialist.

[Andrea0414]

ASMA is anti smooth muscle antibody and is usually seen in autoimmune hepatitis. Rash can also be found in this form of hepatitis. Yes, hopefully, the Rheumatologist will be able to help.