sarcoidosis?

[penny262]

I am a 55yo female and was Dx with Lupus 12 yrs ago, however have had 2 episodes of respiratory failure in 2005 and 2009. I understand that I was given solumedrol 40mg q 4h IV and after 10 days being on a ventalator I finally recovered. I have had a sense of just not feeling well, arthralgias, gout, and seems as if I breathe something in that starts these respiratory issues. I have been on prednisone for 10 yrs, currently on 5mg in am, and 2 mgs at night. I was taken off immuran in June due to hospitalization for pancytopenia. First time this respiratory failure occurred, I was on Methotrexate, the second time I was on Immuran. My ANA was positive and my titer was 1:320, and the ANA pattern was nucleolar in 1998. I looked up Sarcoidosis and I fit the ethnic group, and the sx seem to fit me, but noone has ever said I have enlarged lymph nodes on CT or CXR. I know sx of autoimmune diseases overlap. Do you think this could be sarcoidosis? and Can you have both lupus and Sarcoidosis? My father has some sx also seem to fit. Would either parent have to have it for me to have it?  Seems like all females in my family have health issues. Aunt with sever Rheumatoid Arthritis. Is there any genetic testing that can be done to see if this could be my health issues? Both my parents are still living but are 79 and 80yo. Any suggestions?? I have 3 children that one had severe asthma until he was about10, a 33yo daughter with bad exzema and and croup as a youngster, and a 30 yo son with minimal exzema I'm seeing a rheumatoligist, but he is on vacation this week.

[penny262]

Thank you for your reply

[Dr. Kokil Mathur]

Hi!
Well, yes, you can have both sarcoidosis and lupus. Sarcoidosis can cause lung scarring which can precipitate respiratory failure like situation during an acute attack. Yes, autoimmune disorders run in families and certain individuals have the genetic predisposition towards autoimmune disorders. Since you have a strong family history, it would be a good idea to go for genetic counseling. Please log in the complete family history. Ask your parents about who else in the family they think had medical issues pointing towards an autoimmune disorder (including diabetes, hypothyroidism, and rheumatoid arthritis). Write down your immediate family history. Ask your specialist to arrange a counseling session for you. Based on the complete picture the geneticist can advise about the tests required. Hope this helps. Take care!