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06/18/2009 - Questions and Answers

Diagnosing lupus erythematosus

By: Novoviva webmaster

Question

I have pins and needles and sometimes numbness in my left shin bone. My ESR and ANA are elevated, and my doctor referred me to a neurologist.

She immediately told me I have neuropathy and she suggested this was due to lupus. This got me very upset. Do these test results mean that I have lupus?
 

Answer

We advise you to be guided by your neurologist and remain in touch with her while further investigations are done. We understand your reactions and anxiety, but at this time there is only a suggestion of lupus. Here is some general information that may be helpful to you in talking with the physicians.
 

Antinuclear antibodies (ANA) are present in systemic lupus erythematosus, Sjogren's syndrome, mixed connective tissue disease, scleroderma, liver disease, drug-induced lupus, and rheumatoid arthritis. Causes of a high ESR include: systemic lupus erythematosus, rheumatoid arthritis, polymyalgia rheumatica, temporal arteritis, systemic sclerosis, infections, malignancy, multiple myeloma, anaemia of acute or chronic disease, and other conditions. So you see there are many causes for these test results, and some overlapping.
 

Peripheral neuropathy is a common neurological disorder resulting from damage to the peripheral nerves. Although the causes of peripheral neuropathy are diverse, they produce common symptoms including numbness, paresthesia (abnormal sensations such as burning, tickling, pricking or tingling "pins and needles") and pain in the arms, hands, legs and/or feet. Some neuropathies develop suddenly, while others progress slowly over many years. Often the symptoms depend on the type of peripheral nerves damaged and one need not have all the listed symptoms. If "pins and needles" and numbness are the only symptoms this could mean early days (the damage has only begun). A large number of cases are of unknown origin.
 

Lupus is a complex disease whose cause is unknown. It is likely that there is no single cause but rather a combination of genetic, environmental, and possibly hormonal factors that work together to cause the disease. The exact cause may differ from one person to another. Each person's experience with lupus is different, although there are patterns that permit accurate diagnosis. Most people with lupus test positive for ANA; however, there are a number of other causes of a positive ANA besides lupus, including infections, other rheumatic or immune diseases, and occasionally as a finding in normal healthy adults. The ANA test simply provides another clue for the doctor to consider in making a diagnosis. In addition, there are blood tests for individual types of autoantibodies that are more specific to people with lupus, although not all people with lupus test positive for these and not all people with these antibodies have lupus. These antibodies include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), and anti-La (SSB). The doctor may use these antibody tests to help make a diagnosis of lupus.
 

The web sites below inform about peripheral neuropathy and lupus

 

Related Links
NINDS Peripheral Neuropathy Information Page
Systemic Lupus Symptoms, Causes & Treatment

Created on: 06/14/2004
Reviewed on: 06/18/2009

Your rating: None

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