Dr. Ashaq Hussain Parrey
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have GPA which has been in remission for the last year. It usually flares up when I have an infection. But these symptoms are quite odd. They are not normal as they usually are. I looked in the mirror and saw a scab with red dots at first glance—burst blood vessels. But mine has always been purple. But GPA did not even come to mind as I also had a spotty rash on my chest. I got a glass, and the dots did not fade. I have bruising all around my neck, and the veins on my chest are more prominent blue. I am not 100 % sure it is GPA. My tonsils always flare up when there is an infection and also, as a part of GPA manifestation. My ear cartilage started to break down at the start of the year. The areas are where I previously had piercings. But they have been out for five years. I had a blood test three weeks ago, and it was bizarre and unexplained. P-ANCA was positive. Normal levels for MPO PR3. I am just lost on this.
Hello,
Welcome to icliniq.com.
I reviewed your post and image (attachment removed to protect the patient's identity). You have ecchymosis, which is resolving, which is why they look blue. One of the skin manifestations of GPA (granulomatosis with polyangiitis) is ecchymosis, and you are right. It does not always mean active vasculitis. It means the blood leaked is getting reabsorbed, and the blue color is due to the high quantity of deoxygenated blood. If you want to know whether you are still in remission or not, I would suggest a few tests - CBC (complete blood count), ferritin, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), a urine examination, and KFT (kidney function tests). If these tests are normal, it means you are in remission. I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I have uploaded the prescription I was given. I was also diagnosed with tonsillitis the other night. They were not sure whether it was quinsy. I have been given Penicillin and Prednisolone for five days.
Hello,
Welcome back to icliniq.com.
Your reports (attachment removed to protect the patient's identity) say ANCA (antineutrophil cytoplasmic antibodies) is positive. However, only platelet count and kidney function, which are available, are normal among disease markers. However, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), ferritin, and urine examination are not available, which is important to determine the disease severity. If you can do these few tests, it would help. However, the available reports show that the disease is in remission.
Thank you.
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Rheumatology
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