Question
Hi,
I'am 47 yr old female who was recently had some blood work done by a rheumatologist. The panel came back positive for Lupus & sclerederma. The Doctor is NOT wanting to diagnose it as such due to the lack of the rash anywhere. All of my sypmtoms, swollen hands and feet, fatigue, some trouble swallowing(usually at breakfast time or first meals. The x-rays showed no arthritis the only skin symptoms have been small pustules on face looks like acne but hard and nodule like, and the whitish red swollen hands and feet. Is it possible to have BOTH tests be positive and NOT have both of these diseases? This has been going on for several years now and this is the 1st blood test any Doctor has done.

Thank you for your time.

Answer
I don't have any experience with lupus, but the ANA test doesn't diagnose scleroderma. Scleroderma is diagnosed based on your medical history, reported symptoms, and what the doctor actually sees at your appointment(s). The ANAs only support this diagnosis.

95-97% of systemic scleroderma patients have Raynaud's phenomenon, where fingers and toes turn white in reaction to cold or stress due to a spasm in blood vessels, blue as blood trapped in the fingers or toes loses oxygen, and finally red as oxygenated blood rushes back in after the spasm stops.  I know the percentage of people with Raynaud's is lower in lupus, but not sure how much.

If you don't have Raynaud's, odds are good you don't have scleroderma and it may account for your doctor's hesitation to diagnose that.  Keep working with him to find a diagnosis so you can get proper treatment.  I know it can be a long and frustrating process, and some consider it fruitless since in the end you may be faced with a disease with no cure.  But consider that in many cases there are now effective treatments for complications that previously may have been life-threatening.