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Arthritis (Expert Forum)
Which Autoimmune Disease is it?
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.
Which Autoimmune Disease is it?
by Kristina1, Mar 15, 2007 12:00AM
I am a 35 year old woman, 109 lb, 67”.
In 2006 about three months after the birth I started having pains in joints and bones. Joints were more and more sore. For a few months syptoms increase and change: I was very tired,low energy, sleep disturbances, muscle twitching, upset intestine (running stools , yellow gel),burning feeling in feet ,swollen muscles feeling, chest pain,itchy skin, livedo reticulatis in legs and arms, red spots under the skin in wrists and calves, dizziness, ear ringing, ear pain sometimes, flu like symptoms, red itchy scalp in the back of the head, red eyes, plus foot and hand vibrations. All symptoms worsen for a few days and than get a better for some days or weeks.
*BLOOD TESTS (normal results): ANA,ANCA-S, all kind of lupus and RF test.
Dec 2006. Coughed up blood. Broncohoscopy: small amount fresh blood in one lung, no inflammation. Chest x-rays, MRI, Angiography,Kidney ultrasound, normal. MRI Brain: No inflammation of brain vessels.
Doc #1: All symptoms point to an autoimmune disease but tests show no signs of it. No sign on inflammations or infections. Try Prednisolon 25mg for 2weeks (If you get better it’s for sure an autoimmune disease).
I take prednisolon and I feel better, cool feeling in chest, pains and twitchings gone, more energy.
March 2007: I stared having night sweats and morning palpitation. Can’t sleep past 4:00 am. I still have some livedo, red spots, dizziness, ear ringing.(now taking 30 mg at 8:00am, 15mg at 2:00pm).
What kind of autoimmune disease do I have?
In 2006 about three months after the birth I started having pains in joints and bones. Joints were more and more sore. For a few months syptoms increase and change: I was very tired,low energy, sleep disturbances, muscle twitching, upset intestine (running stools , yellow gel),burning feeling in feet ,swollen muscles feeling, chest pain,itchy skin, livedo reticulatis in legs and arms, red spots under the skin in wrists and calves, dizziness, ear ringing, ear pain sometimes, flu like symptoms, red itchy scalp in the back of the head, red eyes, plus foot and hand vibrations. All symptoms worsen for a few days and than get a better for some days or weeks.
*BLOOD TESTS (normal results): ANA,ANCA-S, all kind of lupus and RF test.
Dec 2006. Coughed up blood. Broncohoscopy: small amount fresh blood in one lung, no inflammation. Chest x-rays, MRI, Angiography,Kidney ultrasound, normal. MRI Brain: No inflammation of brain vessels.
Doc #1: All symptoms point to an autoimmune disease but tests show no signs of it. No sign on inflammations or infections. Try Prednisolon 25mg for 2weeks (If you get better it’s for sure an autoimmune disease).
I take prednisolon and I feel better, cool feeling in chest, pains and twitchings gone, more energy.
March 2007: I stared having night sweats and morning palpitation. Can’t sleep past 4:00 am. I still have some livedo, red spots, dizziness, ear ringing.(now taking 30 mg at 8:00am, 15mg at 2:00pm).
What kind of autoimmune disease do I have?
Doctor's Answer
by Kevin Pho, MD, Mar 16, 2007 12:00AM
, Mar 16, 2007 12:00AM
Difficult to say. Comprehensive tests have been done. A negative ANA, RF and ANCA test would make rheumatological disease less likely.
Another test to consider would be a sedimentation rate or C-reactive protein. These tests can determine if there is inflammation present, and can help point to a reactive process. Another opinion with a rheumatologist can be considered to exclude autoimmune disease.
If the tests remain negative, you can look for other systems. This can include a neurology referral - with tests to evaluate the burning the feet (i.e. with a B-12 level and nerve conduction studies).
The palpitations can be further evaluated with an echocardiogram and Holter monitor.
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_
Another test to consider would be a sedimentation rate or C-reactive protein. These tests can determine if there is inflammation present, and can help point to a reactive process. Another opinion with a rheumatologist can be considered to exclude autoimmune disease.
If the tests remain negative, you can look for other systems. This can include a neurology referral - with tests to evaluate the burning the feet (i.e. with a B-12 level and nerve conduction studies).
The palpitations can be further evaluated with an echocardiogram and Holter monitor.
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_
You may want to consider seeing a physician who treats fibromyalgia and CFIDS patients'. There is new research in on CFIDS and some treatments available. If you have CFS... the sooner you get treated... the better ! Unfortunately, an estimated 80% of people who have CFS have yet to be diagnosed.
Most of the symptoms you listed, and especially the ringing in the ears, can all be due to CFS or fibromyalgia.
I guess I have to do all the testing (next is the biopsy) hoping thay are all normal before they can rule out and Autoimmune disease. But they are thinking Vasculitis.
I definately have many many symptoms of CFSDS too.....
Thank you for the info.
Hi Kristina,
Good luck with your biopsy. If you do get diagnosed with CFIDS, you may want to google "Marshall Protocol". I'm currently on this protocol and getting better... slowly, but surely !
I was diagnosed with rhuematoid arthritis about eight years ago. Two years ago I switched to my fourth rheumatologist because I wasn't getting any results from the many RA treatments I had been on (I was infact getting many adverse reactions from the treatments). This new doc decided I didn't have RA, but instead fibro. My blood tests for the past eight years have always come up very high rheumatoid factor, positive ANA screen, and elevated sed rate during intense flare ups. In the past few years my ANA screen has started coming up with a speckled pattern. Bone scans at the age of 26 showed mild uptake and arthritis in the hands/fingers, wrists, ankles, feet, and hips. The nuerological symptoms I started developing after giving birth are worsening to a degree of disability and are consistent with MS. I am now seeing my third neurologist and she is conducting all of the necessary tests to try and find MS (MRI's of brain, spine, and neck;EEG; EVP's;lumbar puncture;NCS). I am NOT convinced I have fibromyalgia. I just think I have too many physical findings to say this is all just fibro. I am about to change rheumatologists once again.
I am not trying to scare you or sound like a complainer. I just want you to know what it took me eight years to figure out. They can pretty much tell you have something, but knowing for sure what it is could take years. Once you do get diagnosed, it almost never a 100% diagnosis. There are so many females in my family dealing with autoimmune diseases. We have all been through the same frustrations you are going through. Don't feel alone. Do as much research as you can on all of the autoimmune diseases, and don't give up until you have answers. Let me know if you have any questions.
Jenn
Hi Jenn,
I just read your post to Kristina and looked for a research study I read recently on patients' who have fibro, but have positive labs. I have CFS and I also have a high ANA titer (1:640 - speckled pattern). I just hope you can find a treatment that is working for you. Anyway, here were the results from the study:
"Our results revealed abnormalities of the following inflammatory Markers: ESR elevated in 26.9% ( n=160 ) and CRP high in 36.6% ( n=231 )
Serological abnormalities included 29.3% ( n=185 ) positive ANA and 21.5% (n=136) positive RF." (rheumatoid factor)
source:
AB0765 INFLAMMATORY FIBROMYALGIA : IS IT REAL ?
S. K. Metyas1, D. G. Arkfeld2, J. A. Ibrahim3, G. Ehresmann2
1Rheumatology, University of Southern California - Keck School of Medicine, 2Rheumatology, University of Southern California- Keck School of Medicine, Los Angeles, 3Rheumatology, Research associate, Covina, California, United States