My 16 year old daughter is having problems with frequent aphthous ulcers in her mouth. Blood work by family doctor included
CBC - normal
C Peptite <16
Sed Rate 11
Vitamin B12 normal
Vitamin D normal
Her ANA screen, IFA is positive with homogeneous pattern and ANA Titer 1:320
She does not have any other symptoms, rashes, fevers etc.
The reason we took her to the doctor was frequent aphthous ulcers in her mouth.
Her past medical history is only positive for a salivary duct stone years ago that was surgically removed and she has been noted to have benign hematuria. She was evaluated by renal ultrasound a couple of years ago.
She is on no medications other than a multiple vitamin.
Parent family history - mom has benign hematuria that has been evaluated by cystoscopy, renal ultrasound and frequent follow ups.
They are setting her up to see a pediatric rheumatologist in the near future.
Your thoughts as it pertains to this ANA postive, homogeneous pattern and 1:320 titer. What about the benign hematuria here? Any connection?
Well a titre of 1:320 is considered high as we keep the cut-off as 1:200.
Also since ANA is positive, i have a suspicion about Lupus trend.
However i her joints are perfect, we really can wait and watch.
Would suggest you to just keep her on Vit-B and C supplements and tackle the issue of Aphthous ulcer only and not concentrate on other issues.
As you have mentioned that her Vit levels are fine, then stress ulcer is the only conclusion. Keep her out of stress.
Regarding benign Hematuria, again my suspicion goes towards "Lupus".
Hence please consult a good Rheumatologist, for a better picture.
Please discuss again, once you need the consultant.
I took my daughter to see ENT yesterday.
She has a severe chronic tonsil infection as the tonsils are red, severely swollen, cryptic and ill appearing.
She has been placed on Augmentin and a medrol dose pack and is currently schedule to have a tonsillectomy on August 31, 2010.
Would this explain the blood work and what we have been seeing above or how do you see this fitting into the picture?
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