Lupus Possibility

Hey all.  I'm new to the forum but I have a few questions with regards to Lupus.  First, here is my history.  Back in December/2006 I was diagnosed with Sero-Positive RA.  At that time I was started on MTX and Plaquenil and I've been seeing my Rheumatologist every (3) months ever since.  A little over a year ago I began to develop what, based on my own research appears to be a "malar" rash on my face.  This rash would come and go, get worse after being out in the sun or overheated and will be hot to the touch and sting a little when it comes on.  I brought issue up with my Rheumy a year ago and he stated that it was probably due to light sensitivity as a side effect of the MTX and Plaquenil.  I was advised to cover up in the sun and use sunscreen whenever possible. At the time I accepted his explanation.  However over the next several months I began to notice that I could be in the house for several days without going outside and having the blinds closed and that the rash would still come on. My wife also made note of the fact that the rash almost always comes on or gets worse during an RA flare.  I brought this issue up with my Rheumy again yesterday and he stated that since the issue was still a concern to me and also due to the fact that I've had a consistantly low platelet count for the past (6) months that he would run an "ANA" test to see if SLE Lupus was the culprit.  He stated that the ANA test alone could not confirm the diagnosis of SLE and that if the test came back positive I would have to have more tests. 

Can anybody tell me what other tests other than ANA are used in the diagnosis or SLE/Lupus? 

Can you have a negative ANA test but still have SLE/Lupus?

Also, based on my symptom description above does it sound to you as if SLE is a possibility in conjunction with my seropositive RA?

Any info would be greatly appreciated!

Thanks......Ta2d

Thanks for the link.  That website answered a ton of questions! According to that website the induction of cytotoxic and antimalarial drugs can bring a positive ANA down into the normal range.  Due to my Rheumatoid Arthritis I'm already taking both MTX and Plaquenil and I've been taking these drugs for over 2 1/2 years.  That said, I think there is a very good possibility that I may not show a positive ANA result due to me taking these meds.  If that is what transpires and I get a negative ANA result, how should I proceed since the ANA result may likely be skewed due to my current meds?  Obviously, I can't stop using the MTX and Plaquenil or my RA will flare up with a vengance.  I truly believe that there is a connection between my flare ups and the Malar rash that I've presented with for over a year.  The rash just doesn't seem normal to me. 

The frustrating thing about lupus is that there is nothing "standard" about it.  Some have it but test negative.  Lupus is a difficult disease to diagnose and treat and some patients go years without having confirming lab tests even though there is no question they are sick and have lupus.  Eventually, most patients will test positive and have the confirming lab tests.  If you are being treated the meds can mask these tests in some cases.

Bill