as indicated in the article which discusses ANA and other serum markers, the SSA, SSB and other pertinent antibodies may only present when SLE, Sjogren's or other connective tissue disease is ACTIVE. then they can disappear again. while on DMARD such as plaquenil it is common for the markers to go away (the drug is working) but if you stop, the disease can re activate.
Restasis is the ONLY drug approved by the FDA for severe dry eyes related to autoimmune disease processes. this would be a talking point with your insurance company to pay much more with a lower deductible. Dr Foster often has to write letters regarding off label use of meds.
Dr Foster continues with Harvard Medical School and does surgery at MEEI. He trains fellows in Ocular Immunology at MERSI his clinic (MASS Eye Research and Sugery Institute), he has an infusion clinc at MERSI as well as all Labs.
which lab that does various tests can make a very large difference in results as you probably well know with your background. I have known several individuls who were negative for antibodies for decades before they finally appeared yet they had symptoms of the various disease processes. this is true of SLE and Sjogren's, systemic sclerosis. dermatomyositis etc. even Vascular components showed negative labs until later on. I have also seen individuals with intermediate uveitis who presented with neurological symptoms of MS who only got diagnostic lesions on the brain or spinal cord a couple of decades later, the Central Nervous system can be compromised in the Mixed connective tissue diseases similar to what is present in MS presenting as NeuroMyelitis Optica. this includes transverse myelitis ANTI NMO IgG marker. ANTI RO 52 can present as transverse myelitis in SJogren's and Lupus patients.
if the rash on your face reappears take close up digital photos as well as any other rash that might appear.
are you still type II diabetic or was it corticosteroid induced by oral meds?
Metabolic Syndrome could be present with your high lipids and type II diabetes (I'm diabetic and take meds for it as well as lipids and high blood pressure and neurological disorders.http://www.iritis.org/forum/viewtopic.php?t=1709
I get swelling below my ears just behind my Jaw which can be very painful when my dry mouth stuff kicks in. I have very dry skin as well and my hands and feet will crack if I don't use lotion yet I am negative for the markers for Sjogren's. I don't get mouth sores common to Sjogren's either. I have tinnitus in both ears, a constant high frequency screatch that changes in volume and which makes it difficult to hear in large gatherings.
uveitis is often considered to be an autoimmune disease process when all other causes are ruled out. especially in HLA B27 related uveitis without arthriits. Systemic treatment has to be done for whatever cause in order to calm the beast or it will eventually cause other changes within the eye such as cataract, glaucoma, cystoid macular edema, epiretinal membrane formation, vascularization of the retina with related complicatons of bleeding, etc,. the often recurrent nature of uveitis mandates the use of corticosteroids with initial presentation in order to stop the inflammation; but, other meds such as NSAIDS (celebrex, dolobid, indomethacin SR) or DMARD meds are used in a corticosteroid sparing approach to treatment. although Naprosyn is often used by rheumatologists, the above NSAIDS seem to give the most benefit in Uveitis Patients with trial in the order given to see effect. Dr Foster most often uses Celebrex because it coveres both types, COX I and COX 2 which I believe can be found in inflammation of uveitis as well as joints of the body.
SLE can cause optic neuritis and posterior segment disease too FYI.
I have known individuals with MCTD who had the butterfly rash related to SLE of the face. do you get a rash while out in the sun? often seen in the MCTD"s as well as from Plaquenil and MTX.
Wish you the best,