Help with Test Numbers

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

[Kevin Pho, MD]

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

[myproblem]

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.