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Arthritis (Expert Forum)
Strange illness
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.
Strange illness
by Elisabeth, Jun 04, 2003 12:00AM
I am a 23 year old woman who is in good health. I have a history partial seizures but other than that have always been in good health. In the fall of 2001 I started to develop a rash on the tops of my thighs and on my buttox. This rash was red and in large "splotches" and seemed to start improving and then it would get worse but never completely went away. I eventually went to a doctor and was given antihistimes under the assumption I was having an alergic reaction to something. The symptoms did not improve and I was give predisone (the packaged kind where you take decreased doses over a week or two). This did seem to help and I was rahs free for awhile. :-) That January I started develop soreness in my neck, upper arms, and shoulders that persisted for a week to ten days and made it dificult to get out of bed at times and to dress without pain. This resolved and I was symptom free for a week or so and then I developed pain in my knee. That resolved and then I had pain in my anckles, that relsoved and I had pain in my elbow, then the other one, and then the wrists...ec you get the point. In the begining of Febuary the joint pain subsided mostly but I developed a rash again that started on my arms and then over my whole body. It looked like all my skin had been burnt and was red and swollen. I was also having fevers. i went to an immediate care center and I had a fever of 101. I tested negative for Strep. and ANA but my sed rate was elevated, I was anemic and elevated WBC. I was put on antibiotics which didn't work so I was referered to a reumatologist. He originally thoughtI had dermamyositis due to the dark red rahs on the backs of my hands and circles around my eyes.My LDH, SGOT, and adolase ensymes were elevated but not CPK. I was tested for Hepatisits A,B,C to rule out liver disease. (No jaundice or enlarged liver) and was positive for hepatistis B antibodies. To my knowlege I never had Hep B or the vaccine. At the time the doc didn't think the lab work showed enough enzyme elevation to indicate that I had an active Hep virus and said it appeared I had it at some point. My question is (yes, there is a question in this novel) could this illness have been either a "mild" Hep B infection? Or maybe I seeked treatment just as it was resolving on its own? I ask this because I want to know if I am infectous still and if it is neccesary for me to get a Hep B vaccine.By May 2002 all my symptons resloved and the doctor was stupped. His thory was that I picked up some unknown virus. Your thoughts would be appreciated. I hope this was a one time illness and not anything cronic such as dermatomyositis.
Elisabeth
Elisabeth
Doctor's Answer
by Kevin Pho, MD, Jun 05, 2003 12:00AM
, Jun 05, 2003 12:00AM
Hello - thanks for asking your question.
Hepatitis B surface antibody is positive in people who have been exposed to hepatitis B previously but have cleared the virus from their body. It is also usually positive in people who have been vaccinated against hepatitis B. People who test positive for surface antibody are immune to hepatitis B or are vaccinated; they are not carriers. In your case, it may be present if you have been exposed, but subsequently cleared the virus from your body. I cannot comment on whether there is active hepatitis B without knowing the other results from the panel.
As for whether you are immune to hepatitis B, you can obtain titers of the antibodies. If it is above a certain level, then you are considered immune.
Without examining you, I cannot say whether you have dermatomysitis or not. Any motor neuron disease (amyotrophic lateral sclerosis), myasthenia gravis, the muscular dystrophies, and the various inherited, metabolic, drug�induced, endocrine, infectious and other inflammatory myopathies (i.e. vasculitis, inclusion body myositis etc.) can also present with similar symptoms. Hey should all be considered when your physician gives you the diagnosis.
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.
Thanks,
Kevin, M.D.
Hepatitis B surface antibody is positive in people who have been exposed to hepatitis B previously but have cleared the virus from their body. It is also usually positive in people who have been vaccinated against hepatitis B. People who test positive for surface antibody are immune to hepatitis B or are vaccinated; they are not carriers. In your case, it may be present if you have been exposed, but subsequently cleared the virus from your body. I cannot comment on whether there is active hepatitis B without knowing the other results from the panel.
As for whether you are immune to hepatitis B, you can obtain titers of the antibodies. If it is above a certain level, then you are considered immune.
Without examining you, I cannot say whether you have dermatomysitis or not. Any motor neuron disease (amyotrophic lateral sclerosis), myasthenia gravis, the muscular dystrophies, and the various inherited, metabolic, drug�induced, endocrine, infectious and other inflammatory myopathies (i.e. vasculitis, inclusion body myositis etc.) can also present with similar symptoms. Hey should all be considered when your physician gives you the diagnosis.
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.
Thanks,
Kevin, M.D.
Member Comments (3)
by horsedk, Aug 19, 2003 12:00AM
my wife has been diagnosed with derma myositis...how is it contracted...is it contracet sexualyy or is it contracted genetically../....please help
