Diagnosis help?

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10bmd10
Regular Member


Date Joined Oct 2016
Total Posts : 25
   Posted 10/9/2016 2:34 PM (GMT -7)   
34 year old female. Went to my orthopedic surgeon for chronic wrist/thumb pain that has been going on for 2 years. Xray and MRI are negative so he sent me for blood-work to look into immune disorders.

I came back "out of range" in two areas.

ANA = positive. titre = 1:160 homogenous and speckled.
CRP = 2.3

Also, my lymphocytes are below average and my neutrophils are above average.

Aside from joint pain, symptoms include : chronic fatigue, regular afternoon low-grade fevers, chronic yeast infections, sebhorric dermititis (red scales on scalp), weight gain, some minor shortness of breath, poor short term memory.

Anybody have any symptoms and blood work that is similar? it'll be a while til I get a diagnosis. I dont see my doctor until the 17th, and that's the orthopedic surgeon, so he'll probably just refer me to someone else? Knowing these numbers, should I just go ahead and schedule an appointment with a rheumotologist?

Thanks all!

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 10/9/2016 8:17 PM (GMT -7)   
You need to see a rheumatologist. They have the extensive training needed to identify autoimmune diseases.
Joy
Lupus, RA, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, Depression, Allergies, diabetes, and benign familia tremors

When life throws you lemons....
Pick them up and throw them right back at them! :))

Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7550
   Posted 10/9/2016 8:27 PM (GMT -7)   
Welcome to HW, 10mbd10!

Your numbers and symptoms may indicate some kind of auto-immune disease, however they are general enough so that they may also indicate something else altogether!

You may want to read our Lupus 101 topic - it contains answers to any number of questions you are asking. Here is some ANA information.

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- A titer above 1:80 is usually considered positive.
- Some laboratories may interpret different titer levels as positive, so one cannot compare titers from different laboratories.

* The pattern of the ANA test can sometimes be helpful in determining which autoimmune disease is present and which treatment program is appropriate.
- The homogeneous, or smooth pattern is found in a variety of connective tissue diseases, as well as in people taking particular drugs, such as certain antiarrhythmics, anticonvulsants or antihypertensives.
- This homogenous pattern is also the one most commonly seen in healthy individuals who have positive ANA tests.
- The speckled pattern is found in SLE and other connective tissue diseases
- The peripheral, or rim pattern is found almost exclusively in SLE.
-The nucleolar pattern, with a few large spots, is found primarily in people who have scleroderma.

Because the ANA is positive in so many conditions, the results of the ANA test have to be interpreted in light of the person's medical history, as well as his or her clinical symptoms. Thus, a positive ANA alone is never enough to diagnose lupus. On the other hand, a negative ANA argues against lupus but does not rule out the disease completely.

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Typically, four or more of the following criteria must be present to make a diagnosis of systemic lupus. The “Eleven Criteria”:

1. Malar rash: butterfly-shaped rash across cheeks and nose
2. Discoid (skin) rash: raised red patches
3. Photosensitivity: skin rash as result of unusual reaction to sunlight
4. Mouth or nose ulcers: usually painless
5. Arthritis (nonerosive) in two or more joints, along with tenderness, swelling, or effusion. With nonerosive arthritis, the bones around joints don’t get destroyed.
6. Cardio-pulmonary involvement: inflammation of the lining around the heart (pericarditis) and/or lungs (pleuritis)
7. Neurologic disorder: seizures and/or psychosis
8. Renal (kidney) disorder: excessive protein in the urine, or cellular casts in the urine
9. Hematologic (blood) disorder: hemolytic anemia, low white blood cell count, or low platelet count
10. Immunologic disorder: antibodies to double stranded DNA, antibodies to Sm, or antibodies to cardiolipin
11. Antinuclear antibodies (ANA): a positive test in the absence of drugs known to induce it.
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Since you do have some symptoms that are bothering you, and since your ANA is slightly elevated, yes, I'd go ahead a make an appointment with a rheumatologist. However, just give the Dr the facts, don't give him a particular disease to think about - I find that limits what they explore.

To locate a rheumy...

I suggest checking with the Lupus Org at www.lupus.org to find your local chapter of the organization. Then check in with the local chapter to see which local Drs are active on the advisory board -- these are generally the Drs most interested in and most experienced with Lupus in your area.

Good luck, and let us know how it goes!
Lynnwood, Lupus & Sjogren's Moderator, Dx: 2000
DIAGNOSING LUPUS & HW's LUPUS 101
"Life is far too important to be taken seriously." - Oscar Wilde
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