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Arthritis (Expert Forum)
Vasculitis?
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.
Vasculitis?
by deedee4, Jun 25, 2004 12:00AM
My hands have become very sensitive to any pressure and touch, especially my finger tips. I have problems carrying my briefcase and chopping food. A red line or mark is left even with the slightest amount of pressure. The skin on my hands doesn't feel as resilient as it use to. It hurts to crumble up a piece of paper or to use a paperclip. Both leave dents in my hands.
If my hands are down below my heart they take on a red reticulated look. If I hold them above my head they go back to the normal white color. Sometimes my fingers will tingle and throb when I've been using them alot. Also, sometimes I can feel heat coming off of my hands. If I'm in a very hot room, above 85, my hands will go red and throb. Often in the morning when I wake the two end fingers on my left are numb.
I had blood test for lupus and ms which were normal. My other blood work is also normal, sed rate, c reactive protein and ANA anti-bodies. All other blood normal. MRI of brain also normal. MRI of spine doesn't indicate any problems that would cause my hands to hurt.
Also I have a problem with dry skin all over by body. Clothes feel like sandpaper against my body. Also, have red bumps on tongue and it is sore.
Is it possible to have vasculitis with normal sed rate and c reactive protein? What doctor treats vasculitis, vascular or rheumatologist?
My doctors are stumped. Are they any other diagnosis that should be considered?
Thank you in advance for your help.
If my hands are down below my heart they take on a red reticulated look. If I hold them above my head they go back to the normal white color. Sometimes my fingers will tingle and throb when I've been using them alot. Also, sometimes I can feel heat coming off of my hands. If I'm in a very hot room, above 85, my hands will go red and throb. Often in the morning when I wake the two end fingers on my left are numb.
I had blood test for lupus and ms which were normal. My other blood work is also normal, sed rate, c reactive protein and ANA anti-bodies. All other blood normal. MRI of brain also normal. MRI of spine doesn't indicate any problems that would cause my hands to hurt.
Also I have a problem with dry skin all over by body. Clothes feel like sandpaper against my body. Also, have red bumps on tongue and it is sore.
Is it possible to have vasculitis with normal sed rate and c reactive protein? What doctor treats vasculitis, vascular or rheumatologist?
My doctors are stumped. Are they any other diagnosis that should be considered?
Thank you in advance for your help.
Doctor's Answer
by Kevin Pho, MD, Jun 28, 2004 12:00AM
, Jun 28, 2004 12:00AM
A rheumatologist would typically treat vasculitis. You already have had some normal bloodwork that would rule out most of the more common rheumatological causes. Other lab tests to consider would be an ANCA study (to evaluate for microscopic polyarteritis as well as a disease known as Wegener's granulomatosis), as well as serum complement levels.
More specialized testing, including an electromyelogram, tissue biopsy, as well as an anteriogram can also be considered for further evaluation.
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.
Medical Weblog:
kevinmd_b
More specialized testing, including an electromyelogram, tissue biopsy, as well as an anteriogram can also be considered for further evaluation.
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.
Medical Weblog:
kevinmd_b
Thanks,
Kevin, M.D.
My point is to simply find a good doctor who will try to identify what is wrong instead of chasing phantom problems while you are forced to put your life on hold for several months. This doctor didn't even bother to have blood taken to check for inflammatory possibilities and has done nothing but waste my time. I had to demand the recent blood tests from my GP or they wouldn't have been done to this day. Good luck.
s, X'rays, and bone scans left me knowing what I did not have, ruling out many items however never really pin pointing the initial cause. My diagnosis was cervical disc disease and chronic myalgia in the thorasic area, causation a repetitive motion injury. The severe thorasic/cervical back pain I now have has responded moderately to common therapies with the best coming from several commonly used sources, routine botox injections, massage therapy, and continual dosages of morphine sulphate. I had never experienced anything like this before, now my life has down a complete 180 degrees, having to leave my place of employment for 24 years that I so much enjoyed. I am now on permanent long term disablity, like I mentioned big time life change, however, I have made the best of what I have. Life has continued on, I have recently got married and have a fantanstic support group that I attend regularly of individuals that have similiar problems that have affected their life and lifestyles. Together we help each other to make the best of life and realize that even with our disabilities we are fortunate, as there are many others that are far worse than us. Don't give up, keep looking forward, and don't be afraid to manage your health with the help of a great professional. It is a team effort with you in the leading role, there to advise the health care provider of what you see as the positives in the treatments provided and where potential avenues can be followed in order to help you get the maximum comfort and quality of life you can given the problems you may be facing. Together the two of you can draw up a plan to follow that will help you both succeed in your goals.