Q. I have arthritis in my neck and wrist for more than ten years and it has worsened now. Kindly help.
Hello doctor,
I am having symptoms of arthritis in my neck and wrist for more than ten years, and it is getting worse now. I thought it could be due to the effect of wear and tear of my old car accident. And sometimes, I convince myself by saying that it is because of aging. I also had back-to-back miscarriages within two years. My joint pain is extremely worse, and I started having new symptoms like facial numbness.
I was suspected of having lupus by my general practitioner. But she did not confirm the diagnosis and suggested me consult a rheumatologist. It happened a year ago. My symptoms are getting worse, and I feel so desperate to feel better. But, I could not get an appointment from a rheumatologist for the whole year; online consultations were also unavailable. Waiting months for treatment seems like torture.
Kindly help.
Hello,
Welcome to icliniq.com.
The symptoms you have described could be seen in lupus or other connective tissue diseases. Your ANA (antineutrophil antibody) is repeatedly positive. However, the ANA profile does not show any specific antibody. But that does not confirm that you cannot have a connective tissue disease (attachments removed to protect the patient’s identity).
Also, the history of miscarriages suggests that you may have the anti-phospholipid syndrome. To confirm, I am advising you on a few more tests like anti-cardiolipin IgG (immunoglobulin G), IgM (immunoglobulin M), lupus anticoagulant, and direct Coombs test.
Your CRP (C-reactive protein) is relatively high, which suggests ongoing inflammation. For symptomatic relief, I suggest you take tablet Prednisolone 10 mg once daily after breakfast and tablet HCQS 300 mg (Hydroxychloroquine) once at night after consulting with your primary physician. These medicines will help you with the symptoms. You might need some more medication according to your response to treatment.
Regards.
Hello doctor,
Thank you for your reply.
Why is my ANA pattern changed from homogenous to nucleur dense speckles over time?
Thanks.
Hello,
Welcome back to icliniq.com.
ANA pattern on immunofluorescence is subjective, especially if the intensity is low. To confirm the antigen associated with your ANA, you can get a full ENA (extractable nuclear antigen) profile. The test you have done does not include all the antigens. Also, ANA could be against multiple antigens in the same person, leading to a change in pattern.
Thanks.
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