Dr. Ashaq Hussain Parrey
Rheumatology
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Patient's Query
Hi doctor,
I think I have an autoimmune disease. Hands hurt for no reason at all. I tested negative for sjogren's syndrome, lupus, and rheumatoid arthritis. I am tired all the time and have no appetite. I am currently taking tablet Lexapro (Escitalopram Oxalate), tablet Adderall (Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate), and tablet Junel (Norethindrone Acetate and Ethinyl Estradiol). I underwent an antinuclear antibodies test, blood sugar test, and thyroid test. I have a titer value of 1 : 1280. What test should I take next, doctor?
Thank you.
Hi,
Welcome to icliniq.com.
Speckled antinuclear antibodies are seen in mixed connective tissue disease (MCTD) and scleroderma. If you have raynaud's phenomenon, do an echocardiogram (ECHO) to look for pulmonary artery hypertension, a high-resolution computed tomography (HRCT) of the chest to assess interstitial lung disease, and creatine phosphokinase and lactate dehydrogenase to look for muscle involvement. If all are negative, wait and watch for arthralgias.Tablet Hydroxychloroquine will be enough to take (consult with a specialist doctor, discuss with him or her and take the medicine with their consent) as it seems like undifferentiated connective tissue disease (UCTD).
Regards.
Patient's Query
Hello doctor,
Thanks for the response.
My hands turn red when cold and not white. I did not expect mixed connective tissue disease because the sjogrens and rheumatoid arthritis tests were negative.
Thank you.
Hi,
Welcome back to icliniq.com.
Raynaud's phenomenon is a classic sign of scleroderma and mixed connective tissue disorder. However, you need to understand correctly what raynaud's phenomenon is before negating it. The first clue to diagnosing mixed connective tissue order is high speckled antinuclear antibodies.
You also need to check the U1RNP antibody levels.
Thank you.
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Rheumatology
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