Arm and Leg Pain - PAD?

[Rachel316]

Hi All,
I am a 24 year old female. I had a pacemaker implanted when I was 19 for bradycardia. I also have Raynaud's and my ASO titre is elevated at a 500. Over the years I have had limb pain and it seems to be getting worse. My legs are very achy right now and the only thing that alleviates the pain is laying down. Every medical sight I look at points to Peripheral Artery Disease. However, my HDL cholesterol is high, but my LDL is low, I have low blood pressure, I'm a normal weight and exercise regularly. Could this be PAD? Or another neurological or circulatory disorder? Any advice is appreciated.

[Dr. A. Srivastava]

Thank you for your question. As you know that streptococcus infection is the most common cause of an elevated ASO titer. Other causes that may raise ASO include bacterial endocarditis, post-streptococcal glomerulonephritis, rheumatic fever, and scarlet fever.  These conditions can be evaluated in respective with an EKG, kidney tests, including analyzing the urine sediment. However, a doctor’s clinical evaluation is essential to get a more specific opinion here. Hope this helps.

[Rachel316]

Hi Dr. Anurag,

Thank you very much for taking the time to respond to my questions. I have seen a nuerologist and a vascular specialist in the past. They both disregarded the symptoms because I do appear healthy. What tests can be done to test for blood clots and the such? I would like to have a list of tests to request upon my next visit. Also, my ASO titre is elevated at 550. They put me on azulfidine and keflex. I have been on this for about 7 months now and have seen a slight increase in my ASO, rather than a decrease. I know you can not diagnose me over the web, but perhaps you can give me a list of tests to request? I really appreciate your time.

Thank you in advance,

Rachel

[Dr. A. Srivastava]

Thank you for your question. Although without being able to examine you I can not offer you the specific advice on diagnosis and treatment that you need, but I would try to provide you some relevant information about your health concern.

From the symptoms you describe, it sounds that it could be a circulatory disturbance (due to compression of blood vessels) or a nerve pinched.  This may most likely occurs due to any clots in blood vessels or raynaud’s phenomenon. I would suggest evaluating all the possibilities with the help of a doctor first. Further referral to a neurologist will surely help you in getting a more precise opinion here. Hope this information proves help you.