Q: I belong to India and residing in USA for last 5 years on a job and my wife is here with me for last 3.5 years. She is 43 years old. Recently, when she had the problem of her fingers/palm turning pale, she was advised blood tests and the doctor suspected Lupus and recommended to visit a rheumatologist. We took an appointment with a specialist but his waiting time is 40 days. In the mean time we are getting very worried, as she is feeling uncomfortable due to swellings in fingers, etc. It will be of great help to us if you can please suggest us how to go about this? Blood test results about anti nuclear antibodies is as follows while others are normal: Pattern homogeneous, titre 1:60; Pattern specked, Titre 1:640. Please advise.

A:The symptom you are describing is called Raynaud's phenomenon. In the presence of significant titres of anti-nuclear antibody (ANA test), it almost certainly confirms that she has one of the systemic autoimmune diseases the commonest being systemic lupus erythematosus or SLE. However, there are other sister diseases to SLE (e.g. Sharp syndrome that is also often also called MCTD, systemic sclerosis and others). While the treatment of Raynaud's is basically to protect against cold-exposure, there are several newer drugs that actually act at the root of the disease at the level of the aberrant immune system. These drugs are prescription drugs that only your rheumatologist can prescribe and that too only after identifying which one of the different systemic autoimmune disease she has. Under these circumstances my advice would be try to get the appointment dates advanced or try another rheumatologist who can examine her at an early date.