Could a large minority of cases be seronegative Lupus?

[drob31]

I realize it doesn't cover everyone, but could it cover 10% or more?

• Lupus is the autoimmune version of Lyme in the sense that it's "The Great Imitator."
• It can attack any system in the body and cause nearly any symptom.
• The ability to affect any organ system could cause incalculable problems.
• Many Lupus patients have HPA-axis issues and low cortisol, or general HPA-axis dysfunction.
• People with Lupus can have flares after exercise that are delayed by hours or days and bring on their symptoms which could be flu-like.
• Lupus causes unrefreshing sleep
• You can have a negative ANA and still have Lupus

http://www.lupus.org/resources/15-questions-fatigue-and-lupus

 

[justy]

I strongly suspected Lupus and eventually saw a rheumy who agreed this could be the case. My ANA is low titre positive, but from a private lab so the UK NHS doesn't recognise it. I had full work up for Lupus but it has been discounted - I did ask them about seronegative lupus but they wouldn't have it.

I meet the St Thomas's alternative criteria down to a tee - but cant get anyone interested in it.

Since then I have seen an M.E specialist who has diagnosed chronic infections and an awry immune system, so even if I had Lupus this could be underlying it. Who knows?

 

[drob31]

I strongly suspected Lupus and eventually saw a rheumy who agreed this could be the case. My ANA is low titre positive, but from a private lab so the UK NHS doesn't recognise it. I had full work up for Lupus but it has been discounted - I did ask them about seronegative lupus but they wouldn't have it.

I meet the St Thomas's alternative criteria down to a tee - but cant get anyone interested in it.

Since then I have seen an M.E specialist who has diagnosed chronic infections and an awry immune system, so even if I had Lupus this could be underlying it. Who knows?

Yeah, it's the chicken and the egg story. I would assume a pathogen would some how contribute to the autoimmune condition though.

 

[WillowJ]

I don't know, but I think a patient with Lupus but no anti-ds-DNA antibodies would still have high CRP, changes in complement proteins, or some other traditionally used marker of inflammation in addition to +ANA. I think that's why I don't get diagnosed with Lupus.

It's confusing, though, because some of us have +ANA even high levels, and may have localized organ problems, and the symptoms are all so similar (even "brain fog" and random neurological issues). Of course, many diseases are similar in symptoms and a few non-central pathologies.

 

[Eeyore]

I do not think this makes sense. Lupus is very well known to cause lots of measurable end organ damage. The immune system in SLE will destroy the body without (and sometimes with) severe immunosuppression. If this were the case in ME, we wouldn't see patients getting decades of normal tests. Even a metabolic panel would look grossly deranged, and physical signs would be obvious to any moderately competent physician.

As they say on House, "It's not lupus."