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Arthritis (Expert Forum)
Help with Test Numbers
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
Help with Test Numbers
by hill.diane, Apr 04, 2006 12:00AM
July 2005 having foot pain/limited swelling - exam with orthopedist included ANA test which was negative. Saw my GP who prescribed a Medrol Pak which knocked the inflammation out. September 2005 thought I had pulled shoulder due to hurricane preparations, shoulder ortho saw nothing in xrays and thought I has a sprained shoulder. Pain continued to other shoulder - shoulder ortho said muscle problem. Saw chiropractor, did xrays indicated neck discs compressed. December 2005 still having shoulder/neck/arm pain see neck ortho – nothing in xrays, mri is fine. GP referred me to rheumatologist with the following tests results. Dr. saying RA or Lupus. All my numbers look so low compared to what research I have done for RA or Lupus – maybe MCTD? Or something else? Still having foot/arm/shoulder pain but under control with 200mg Celebrex and 4mg prednisone but he wants me on plaquin(sp) with these low numbers?? Still issues with Reynaud’s when cold but have never had fatigue, rash, ulcers or other items listed on RA or Lupus tables.
Out of Range Tests -----
RH Factor 43
ANA Positive – speckled pattern – 1:640 titer
C-reactive protein 7.23
RNP Antibodies 652
Additional Test within Range -----
C4 & C3 138 / 28, respectively
SED 6
Anti DNA 13
Smith Antibodies 30
Comprehensive Metabolic Panel
CBC (white 7.6 / red 4.3)
Sjogrens
Urinanalysis
Out of Range Tests -----
RH Factor 43
ANA Positive – speckled pattern – 1:640 titer
C-reactive protein 7.23
RNP Antibodies 652
Additional Test within Range -----
C4 & C3 138 / 28, respectively
SED 6
Anti DNA 13
Smith Antibodies 30
Comprehensive Metabolic Panel
CBC (white 7.6 / red 4.3)
Sjogrens
Urinanalysis
Doctor's Answer
by Kevin Pho, MD, Apr 05, 2006 12:00AM
, Apr 05, 2006 12:00AM
A positive ANA with a 1:640 titer can certainly be considered elevated. Note that 1:640 is more positive than 1:80.
This can be associated with a variety of rheumatologic conditions and other antibodies - including Sm (associated with SLE), RNP (Mixed Connective Tissue Disease), SSA (Sjogren's Syndrome-SICCA complex and SLE) and Scl-70 (scleroderma). Specific assays for Sm, RNP, SSA, SSB or Scl-70 can be ordered.
Your elevated RNP levels certainly can be suggestive of MCTD.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
This can be associated with a variety of rheumatologic conditions and other antibodies - including Sm (associated with SLE), RNP (Mixed Connective Tissue Disease), SSA (Sjogren's Syndrome-SICCA complex and SLE) and Scl-70 (scleroderma). Specific assays for Sm, RNP, SSA, SSB or Scl-70 can be ordered.
Your elevated RNP levels certainly can be suggestive of MCTD.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Member Comments
by myproblem, Apr 06, 2006 12:00AM
The Dr. may want you on Plaquenil so he can get you off the prednisone. I assume you know that long term use of prednisone comes with a long list of risks. Loss of bone density is probably the scariest. MCTD is a possibility, but the treatment for MCTD, Lupus, and RA are all about the same anyway. Plaquenil has been around for a long time, is relatively cheap, and has a very low risk. Probably the safest choice, though not always effective. Have you been tested for antiphospholipid antibodies? This would increase your need for Plaquenil, as it decreases clotting risks in those with antiphospholipid antibodies. Do a search for "Plaquenil and Lupus" and you will find more information on this. Also look at "antiphospholipid antibody syndrome" which is common with Lupus, and other autoimmune disorders.
