Rheumatoid Arthritis and Lupus? Is it possible?

reggielvr123 · Newbie Alert Joined: 04 Jul 2008 Posts: 2

I was diagnosed with RA in 1998. I have been on many meds. I had been taking Humira for about 2 years. About 4 months ago I started getting an itchy rash (never before had any skin problems) I also got the butterfly rash on my cheeks, but it doesn't itch. I also get little larger than a marble size lump (where ever they want to show up). It starts out as a small lump, then the area swells, gets red and hot, and feels like someone hit me with a hammer (these lumps always dissappear in 24 hours). And of course, the swollen and stiff joints, from the RA and fatigue. On my regular trip to my rheumatologist, I told him about the new lumps that pop up and about all my itching. He said back in 1998 my ANA was 1-40. He did more tests to test for Lupus. The tests came back with my ANA being 1-640 and DNA 1-320, and some other tests I can't remember, but he said they all indicated lupus. He took me off the Humira and put me on Enbrel. He is hoping, and I am praying, that that the Humira started giving me the drug induced lupus.

He put me on 40 mg prednisone a day for 7 days, 30 mg for 7 days, 20 mg for 7 days, and 10 mg for 7 days. Then I have an appointment to go back for more tests.

Does anyone have both RA and lupus? Has anyone ever gotten drug induced lupus? I'm so scared right now, I don't know how I will deal with it, if it turns out I do have lupus and not the drug induced lupus, along with my RA.

KathyW1958 · Grizzly Bear Joined: 12 Jun 2008 Posts: 702

Hi Reggie,
I am glad that you have come to the forum and want to welcome you. I have heard that there are some folks with both RA and Lupus, but the two illnesses are separate of each other. I have SLE, but not Rheumatoid Arthritis. I have heard of drug induced Lupus. There was a man in the Rheumatologists office where I go that the same thing happened to him on Humara and the doctor changed his medication. He has RA and he was talking about the same thing as you. He said that once his medication was changed that the Lupus symptoms disappeared. I hope that this is the case with you. Saysusie will answer as she is very knowledgeable. I hope and pray for your sake that you do not have true Lupus. Hugs,
Kathy
_________________
Lupus for many years. Like most of my life. Sjogrens that started at 35 and Spinal Stenosis, Degenerative Disc Disease, Osteo-Arthritis of the spine, Ankylosing Spondilitis, Periferal Neuropathy, mild CP and now just recently diagnosed with PA. I had a disc replaced in December of 2007.

Medications:
Plaquenil, Sulindac, Imuran, Celiac diet, Tramadol and B12 shot once a month.

mela · Tadpole Joined: 04 Jul 2008 Posts: 18

Hi Reggie,

I seem to have the opposite situation, my original diagnosis was lupus.
Although I have been on many meds, I am currently on Humira for the lupus. In the past 6 months the joints in my hands have been swelling up to the point that the skin turns a little purple. My rheumatologist said that all clinical symptoms pointed to RA. I asked her if it is possible to have both lupus and RA and she said that since they are both autoimmune diseases that an overlap is possible. I am still on Humira but in my case I did have all the lupus sympotoms BEFORE the Humira. Hope this helps!

sits_inthe_corner · Posted: Sat Jul 05, 2008 5:07 pm Post subject:

Hi reggie and welcome Smile

I don't know alot about RA but it wouldn't suprise me in the least to find out that yes both are possible. Lupus seems to join up with other conditions.
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Saysusie · Posted: Sun Jul 06, 2008 8:40 am Post subject:

It is not only possible, but too often, it is the case! Also, many of us were diagnosed with RA prior to getting our Lupus diagnosis. RA and Lupus have so many similarities and the same positive lab tests that doctors often will tell us that we have RA. Then, after running more tests or after specific lupus tests and/or symptoms appear, we will then be told that we have Lupus!

They are both auto-immune disorders with the big difference being that RA can cause crippling arthritis with deformities. Lupus causes arthritic pain, but no deformities.

I would venture to say that your doctors will continue to test you during the course of your illness to see if you do, indeed, have overlapping diseases or if you have one or the other!

Peace and Blessings
Saysusie
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Look For The Good and Praise It!

reggielvr123 · Newbie Alert Joined: 04 Jul 2008 Posts: 2

Thank you for all the replies, it's not really what I wanted to hear though. I was hoping that you either have RA or lupus and never both. I'm pretty positive that I do have RA because in the last 3 years I've had 2 surgeries to remove, what the surgeon said were rheumatoid nodules, on my knees. And I do have a nodule on my foot that isn't bothering me to warrant surgery for removal. Unless, do you get nodules with lupus? I guess I didn't think to ask that at my last appointment.

Saysusie · Posted: Tue Jul 08, 2008 9:57 am Post subject:

Rheumatoid nodules are rare in lupus patients who do not have arthritis and the concomitant presence of these two diseases in the same patient is also rare. As part of the rheumatoid process, firm, non-tender, subcutaneous nodules develop in about 25 percent of rheumatoid arthritis patients. These are commonly found at pressure points like the elbow, back of the forearm, and metacarpophalangeal joint. Nodules usually occur in chronic active cases of rheumatoid arthritis, and are commonly associated with more joint deformity and serious extra-articular manifestations including lungs, eyes, and blood vessels. Nodules may vary in size during the course of the disease process.
In rheumatoid arthritis, the presence of these extra-articular lesions correlates with the extent of joint involvement and they are an index of disease severity. However, they may also occur in rheumatic fever or rarely in systemic lupus erythematosus.
As I mentioned, it is rare to have these with SLE. However, most of those cases of SLE with rheumatoid nodules were found to have antiphospholipid syndrome: a disorder of coagulation, which causes blood clots (thrombosis) in both arteries and veins. The syndrome occurs due to the autoimmune production of antibodies against phospholipid (aPL), a cell membrane substance. In particular, the disease is characterised by antibodies against cardiolipin (anti-cardiolipin antibodies) and β2 glycoprotein I.
So, while the nodules are common to RA, they do occur, on rare occasions, with SLE.

Peace and Blessings
Saysusie
_________________
Look For The Good and Praise It!