Arthritis

Question
Posted by: Elna | 2017/08/12

Q.

Lupus.

Hi dr I would like you to give me your opinion on the lab result: Anti-inuclear - positive Titre 1:160 Pattern Homogenous Double strand DNA ab 3.9 ENA positisve I have permanent pain for years, especially thigh pain. A deep burning cold pain with electric shocks. Also extreme buttock pain. I always feel very cold. The hair on my thighs stopped growing about 2 years ago. I feel flu like without temperature. I have joint pains in hips, neck as well as lower back pain(4&5 bulging discs) and narrowing of C5-6. I know that the joint pain is degeneration, but I would like to know what treatment will be best without taking 2 Stipanes every day. I use Lyrica 75mg twice a day, anti malaria tablets, Cortisone 5mg a day. It helps a bit, but does not help for the other symptoms. I get quite ill when I am in the sun, so I avoid it. I also have very low bone density especially upper back. Nerve conduction test normal. I get very nauseous of Azapress, which I stopped using. I see a Rheumatologist but wait very long for an appointment. GP prescribed Methotrexate 7.5 mg twice a week. Do you think it is a good idea to take methotrexate instead of Azapress. What else can you suggest for the pain. What is the cause of the hair loss on my legs? I am 58 female. Thank you very much

Expert's Reply

A.

Arthritis expert
- 2017/08/19

The auto-antibody tests you describe indicate probable lupus but the rest of your symptoms are not quite compatible. Methotrexate might help, but it is usually taken as a once-a-week dose. It is probably a better alternative to Azapres.

I think your pain is most likely related to Fibromyalgia rather than lupus. You need to follow a gentle exercise programme, especially swimming.
The pain in your hip and buttock area is most likely due to a trochanteric bursitis and will probably respond very well to local steroid injection.
You should have regular pre-arranged 3 monthly or so appointments with your rheumatologist to avoid long delays.


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