Before Jail, Ben has tested positive for both the ANA, a test that shows auto-immune activity, and the anti-dsDNA, a test that is often positive in lupus. Since being in jail, he has tested positive for both again. According to one doctor, his last ANA result was quite high, suggesting that auto-immune issues may very well be a serious contributing factor to Ben’s illness. Ben satisfies 3 separate sets of classification criteria for systemic lupus erythematosus {SLE, the 1997 ACR, the 2012 SLICC, and the 2019 EULAR-ACR). While that doesn’t necessarily mean he has SLE, it’s certainly significant, and given how sick he is right now, we need to be absolutely certain. It took forever to see a jail rheumatologist in the first place, and when Ben finally had his appointment, he was disappointed to discover that his doctor, who looked like he was fresh out of college, had trouble navigating the medical record system and wasn’t able to access the information he needed in the moment. On the basis of what information he could access, the doctor was not prepared to diagnose Ben with lupus. While it’s possible Ben doesn’t have lupus, there are many other auto-immune diseases that he might have, and the doctor didn’t diagnose him with any of them. Given his high ANA and many disabling symptoms that overlap with autoimmune conditions, we need more confidence. It’s also important to note, that Ben has already established contact with 4 Rheumatologists before jail. One of whom, a USC Rheumatologist, said that she strongly suspected that he had something “connective-tissuey”. Connective tissue disease is another term for auto-immune disease. An aunt on Ben’s mother’s side had lupus. If Ben is suffering from lupus or another auto-immune disease, drugs like Plaquenil are essential to prevent potentially irreversible damage to the brain and body. We want a second opinion from another Rheumatologist or a follow-up appointment to discuss Ben’s issues in more depth.
Â
Made with Bullet