Lupus or Scleroderma???

How do you know if you have Lupus or Scleroderma. I know you can have both at the same time. What are the symptoms? I have Scleroderma in my lungs now and my Dr. asked if I have Lupus in my family. I am having blood tests done now.
Thanks for your help.
Carol

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I just read Dr. Mayes book that was referred to me by a friend on this website. She talks about scleroderma in particular, but also address Lupus and other connective tissue disorders. It is pretty informational and may answer a lot of your questions. I ordered it online.

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Here are the diagnostic criteria for lupus:

http://www.mayoclinic.com/health/lupus/DS00115/DSECTION=tests-and-diagnosis

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Here are the old diagnostic criteria for scleroderma, issued in 1980 for the sole purpose of regulating what patients were allowed into clinical research studies. Unfortunately the American College of Reumatology has taken these criteria off its web site (as nearly as I can tell) without posting a revision:

1980 Criteria for the Classification of Systemic Sclerosis

The American College of Rheumatology (ACR) (former American Rheumatism Association - ARA) has defined criteria, that are 97 % sensitive and 98 % specific for systemic sclerosis (SSc) as follows:

Major criterion:

* Proximal diffuse (truncal) sclerosis (skin tightness, thickening, non-pitting induration)

Minor criteria:

*Sclerodactyly (only fingers and/or toes)
*Digital pitting scars or loss of substance of the digital finger pads (pulp loss)
*Bilateral basilar pulmonary fibrosis

The patient should fulfill the major criterion or two of the three minor criteria. Raynaud's phenomenon is observed in 90-98 % of SSc patients.

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Since then, many doctors have recognised that the above criteria for scleroderma is not good for detecting early disease, or limited systemic scleroderma, which for instance has a greater chance of causing pulmonary hypertension than of lung fibrosis. Nor does it take into account what we now know about antibodies and capillaroscopy. See http://www.springerlink.com/content/n628713n2u603647/

The ACR still, to my knowledge has not published a revised set of criteria. I wish they would get BUSY!

Unfortunately the criteria still do not address the broad array of signs and symptoms that scleroderma patients are known to experience, but here is a starter list, and keep in mind that skin hardening may come late, or never (as in scleroderma sine scleroderma), and that some scleroderms have quite a different set of signs and symptoms than others :

skin hardening
skin swelling, itching, burning
joint problems, tendonitis, friction rubs
difficulty swallowing, esophageal narrowing
gastric reflux, hiatal hernia, watermelon stomach
diverticulitis, constipation alternating with diarrhea
fecal incontinence, urinary incontinence
erectile dysfunction, dyspareunia (sex painful in females)
hair loss, from limbs or head
darkening and mottling of skin (there may be also vitiligo-like light spots, or a "salt & pepper" appearance
calcinosis
Raynaud's
clawing of the hands, tendon contractures
various heart problems. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361099/
pulmonary hypertension (either arterial or venous)
portal hypertension (in the artery leading to the liver)
sensorineural hearing loss and ringing in the ears
myositis (inflammation and deterioration of muscle)
a shrinking of the mouth (microstomia)
affects on the jaws and teeth (TMJ, trigeminal neuralgia, misalignment and loss of teeth)
neuropathy (see many studies at pubmed.org by searching their database for "scleroderma neuropathy"
Dryness of mucous membranes (Sjogren's can go with scleroderma, and may at least partially account for the dyspareunia and dental and gum problems)
narrowing of the tissues at the back of the throat may cause obstructive sleep apnea.
kidney failure
and more rarely, liver or pancreas damage.

P.S. the heart-lung problems and pulmonary hypertension can cause dizziness, a dry cough, and huffing and puffing with mild exertion. The ear problems, gastric reflux and esophageal problems can lead to vomiting.

This is probably not a complete list, but it's what comes to my mind right now. It's MY list from what I have gleaned from many authoritative web sites and articles, and talking to other patients with scleroderma.

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Thank you daddysrainbow. Thank you Daisydo, you went to a lot of trouble sending me your list.
Carol

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Hey Daddysrainbow I would like to get the name of the book you are referring to and has it helped you understand better I am always looking for as much information as I can get. Thanks

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