Q. I am not clear with the diagnosis of my mother's condition. Please clarify.
Hi doctor,
Five years ago my mother was diagnosed with fibromyalgia. I think she also has rheumatoid arthritis. For the past five years, she was managing the pain with anti-inflammatory medicine, Lyrica, Mythycobal, Voltaren injections, herbal creams, etc. You can see the veins in her hands popping out. I also realized that the pain has got worse now. For about 12 months the doctor put her only on Prednisolone 5 mg per day and painkiller when necessary. She was fine till last month but the pain increased in her hands now. In the daytime she is fine and the pain starts mildly in the evening. When she lies down in the bed she gets electrical tingling in her legs by which her sleep gets disturbed. She has undergone several tests last week and I attached them for your reference. She did not consult a rheumatologist yet. What medication can I give to reduce the inflammation and cure her? Her ESR, CPR, and ANA are quite high. The pain in her hands and the tingling in her legs at night are agonizing her life. Kindly provide your expert advice.
Hi,
Welcome to icliniq.com.
First of all your mother does not have rheumatoid arthritis or fibromyalgia. From her reports (attachment removed to protect patient identity) I found that she has connective tissue disorder and the most possible diagnosis would be systemic lupus erythematosus (SLE). The joint pain, high ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), positive ANA (antinuclear antibody), and response to Prednisolone favor the diagnosis of connective tissue disorder. She definitely does not have functional pain which occurs in fibromyalgia. Her pain and suffering are very true. Now to help you better I need some more details: Since how long is she suffering from all these? Is there any frequent reddening of eyes? Does she suffer from oral ulcers or any rash over the nose or cheek after sun exposure? Did she have any past history of heart and lung issues? I would also like to know if her anti-ds DNA (anti-double-stranded DNA) test has been performed.
Thank you.
Hi doctor,
She has been suffering from this condition for the last five years. In the first two years, the pain hit her ankle, then moved to the neck, the wrist, and so forth. It started when my dad was kind of paralyzed and she took complete care of him. She does not suffer from any frequent reddening of her eyes. She denies oral ulcers and rash on sun exposure. There is no relevant past medical history of note. The anti-ds DNA test has not been done yet.
Hi,
Welcome back to icliniq.com.
Please check her anti-ds DNA test in a short period and the laboratories, which perform ANA may also perform anti-ds DNA. She needs Prednisolone for disease activity control. Though it has various side effects, it is essential. She should also be started on Hydroxychloroquine Sulfate (HCQS). This drug helps in the long term. Now for acute pain, she would require an anti-inflammatory painkiller like Etoricoxib. During the winter or during the acute painful attacks she might require treatment with a single shot of intramuscular Methylprednisolone that gives pain relief for two to three weeks. So in short she needs steroids at present. In fact, at big centers, we also use monoclonal antibodies like Rituximab, which is costly but helps a lot in controlling the disease activity. So at present, she should see a doctor, an internal medicine specialist (MD in medicine) and share my opinion.
Thank you.
Was this answer helpful?
|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
Related Questions:
Please suggest some painkiller for my back pain.
.. gone through your query and I can understand your concerns The severe back pain that you have mentioned, suggests some spine related conditions probably IVDP (intervertebral disc prolapse), which might be aggravated by your posture and strain. Read full
How do I manage my rheumatoid arthritis until I wait for my specialist?A high ESR and CRP, as well as a high number of swollen and tender joints, are the other indicators ... You can do gentle exercises for your joints ... Symptomatic measures like hot fomentation and pain gels can help . Read full
Affirmative Sleep TalkingSleep talk therapy is a new type of remedy in which you talk with your kid while he/she is sleeping ... Parents need not worry about these complaints because they can be improved by sleep talk th Read full
Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
iCliniq's FREE Newsletters
Expert-backed health and wellness information, delivered to your email.
Thank you for subscribing to our Newsletters!
Also Read
PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions. Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this. Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades. Read more»
Ask your health query to a doctor online?
Ask a Rheumatologist Now* guaranteed answer within 4 hours.