RA vs. Sjs: How can you tell?

[HL in NY]

Okay, I was reading someone elses thread and they mentioned an elevated RF. I thought about how when I went into my Rheumy for the first time, both her and & thought I had RA because my RF, ANA & CRP were all elevated and I had every single symptom. Then the next round of blood tests came back and the Dx was changed to Sjs. (Elevated Anti SSa & SSb, plus medical history)

But it just occurred to me, why not both? And how can you tell? Is there was test that will rule out RA and rule in Sjs?

I know it doesn't make a lick of difference in my treatment or outcome. In either case, I have inflammatory Arthritis and we're treating it. AND I know my Rheumy is really the person I should be asking, and I will, but I just wondered if there's an easy answer I'm missing.

Heather

[lighthouse33]

I really can't answer your question but I did read an aritcle on the Internet that said that 50% of people diagnosed with Sjogren's will go on to develop either rheumatoid arthritis, lupus and I think the last one was schloderma (Spelling ??) 5 to 10 years after being diagnosed with Sjogren's.  I'm not pushing any panic buttons for myself but I do know people on the forum who have multiple AIs including rhuematoid arthritis. 

[lelole]

I am sure someone a lot more knowledgable than me will be along soon, I am new bnut have been dpoing quite a bit of research! As far as I know the main differences were that the joint pain and swelling in RA causes damage whereas the SJS ones don't.  Also RA has certain features such as morning stiffness and apparently with RA the joints nearest your fingernails are not affected .  Did Rheumy do any xrays of your painful joints?

I may be wrong though!

Leah x

[Scottietottie]

Hi 

I'm with Leah. SjS causes inflammation of the connective tissue and doesn't damage the joints (though they can feel damaged) but RA destroys the joints and will show up in an x-ray.
I haven't read that people go on to develop RA from SjS, that's new to me, but I have read that many people with RA will go on to develop Sjogren's. Autoimmune diseases often travel in packs. 

Many people in here have more than one AI disease going on plus additional stuff.

Take care - Scottie 

[djean87]

i have sjogrens,ra,lupus cant tell which one causes the most problems.wish i could though.sypmtoms overlap each other,and basically take same meds for all of it

[Linda196]

One test that can differentiate between RA and other inflammatory diseases when the RF is positive is Citrulline antibody (also called Anti-citrulline antibody, anti-cyclic citrullinated peptide antibody, anti-CCP). If both CCP and RF are positive, it's considered quite probable that the patient has RA.

[HL in NY]

One test that can differentiate between RA and other inflammatory diseases when the RF is positive is Citrulline antibody (also called Anti-citrulline antibody, anti-cyclic citrullinated peptide antibody, anti-CCP). If both CCP and RF are positive, it's considered quite probable that the patient has RA.

That's right, Linda. The Anti-CCP. (Which reminds me of old Solvet era stuff) I thought there was a test somewhere. I did have that done and it was negative.

Thanks! Brain-fog attacked again. 

Heather

[lighthouse33]

I couldn't find the exact article I was referencing above but here is a link to one that talks about a patient coming down with lupus 15 years after her Sjogren's diagnosis:

http://www2.vhi.ie/topic/sjogrens