Recent Blood Work....

Thanks all. I emailed my rheumy about this and here was her response:

Hi, Brittanee.

I did receive your labs from 3/30/11.

This is somewhat as I suspected. In the post-partum period, you are becoming more immunologically active (low complements, higher titer ANA).

There is not any evidence of organ inflammation, most important kidneys (the urine protein/cr ratio is normal), but we need to keep a close eye on this.

If there are other systems involved, such as joints and muscle, I can really only tell by seeing you.

At this time, the Plaquenil is the most important medication that you have.

Attached is an additional lab slip - please have these completed (additional antibodies, recheck of kidney/urine) in about 1-2 weeks and keep me updated about symptoms.

Thank you,

Rebecca Manno


Rebecca Manno, M.D., M.H.S.
Fellow, Division of Rheumatology
Johns Hopkins School of Medicine
Baltimore, Maryland

I ended up writing back to her with this reply:

Alright I will and as soon as I can set up an appointment to come visit you I will.

Also, if/when things start becoming more active again(i'm thinking the exposure this summer to heat/sun and the fluorescents due to clinicals & possible job/school)what would be the next step we would take in regards to treatment?

And received this back from her as well:


We would treat you with a little bit of prednisone - for as short a time as possible.

If we were not able to decrease or remove the prednisone - then we would be considering steroid-sparing agents such as methotrexate, Cellcept or imuran.


Rebecca Manno, M.D., M.H.S.
Fellow, Division of Rheumatology
Johns Hopkins School of Medicine
Baltimore, Maryland


Would anyone care to comment on the meds/side effects/etc? I was on prednisone for a few days about a yr and a half ago and it worked until i came off it and symptoms got worse. Other than that I have not been on anything besides Plaquenil for 2 yrs and weve tried diff pain meds(Naprosyn 1000mg/day & Neurontin 900mg/day but none of this worked)...I'm also on vitamin supplements etc so were pushing the limit here as to treating things symptomatically with different drugs.

Also, when I reviewed the lab slip the tests she had checked off to be completed were as follows:

Aldolase
CPK
CRP
Complete Urinalysis
Urine Random Protein
Urine Random Creatinine
Anti-dsDNA
Anti-RNP/sm
Anti-SSA/SSB
C3 & C4
CH50
Myositis Panel
RA Diag. Panel
RPR (STS)
Lupus Anticoagulant
RVVT

So I know most of the test she ordered are for myositis etc...I've always thought I had muscle inflammation due to the elevated CPK's and negative EMG's and skin biopsy for small fiber nerve involvement....I just hope one of these tests shows something..they still consider me to have UCTD w/SLE features not officially lupus so itd be nice to get an official diagnosis so we know exactly what we are dealing with...to what extent.