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Doctor insights on: Rheum

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Who treats Fibromyalgia? Neuro? Pain Manag., Rheum? Is thier a well known "Fibro" Dr. Out there somewhere? I would travel anywhere for the best!

Who treats Fibromyalgia? Neuro? Pain Manag., Rheum? Is thier a well known "Fibro" Dr. Out there somewhere? I would travel anywhere for the best!

Any of the above: Rheumatologists, neurologists, pain docs and internists all diagnose and manage fibromyalgia. We have well-established criteria for diagnosis and management of FM, but some care providers are more proficient. Call around to find out which care providers (MD/DO, PA, NP) in your area are good with managing FM, and research online who has a good reputation treating FM. Good luck! ...Read more

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If you have seen a rheum dr and are ANA + 1:640 and negative for everything else. What is left to look for? Sed is elevated as well

If you have seen a rheum dr and are ANA + 1:640 and negative for everything else. What is left to look for? Sed is elevated as well

Infex/Inflam/ca: With anas in the concentration >1:640 (high), follow up testing of dsdna, sm, rnp, ro, la and scl70 may be helpful. If no autoimmune (ai) disorder can be identified, it is important to be seen at minimally 6mo intervals, as an ai may develop (ana may be + before development of disorder). Rarely, cancer may be associated with high ana. Infections causing +ana: viruses, tb, parasites. Drugs may also. ...Read more

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Had + ANA bloodtests every time, several times a year for past 7 yrs (1:160). Went to new rheum & bloodtest showed ANA negative. How? What's this mean?

Had + ANA bloodtests every time, several times a year for past 7 yrs (1:160). Went to new rheum & bloodtest showed ANA negative. How? What's this mean?

+ANA: The ANA level may fluctuate based on a number of different things. The question is why are the still testing it? Unless you have severe hair lose, a facial rash, renal or CNS disease, or joint complaints, I would not keep testing you. I would be happy to do a consult if needed. ...Read more

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Which dr's can order muscle biopsies? Rheum, neuro, pcp?

Which dr's can order muscle biopsies? Rheum, neuro, pcp?

Muscle bx order: Any provider can order a muscle biopsy, but it is not normally ordered except by neurologists and rheumatologists. ...Read more

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Think husband has raynaud's. Better to see rheum or derm? How is it diagnosed?

Think husband has raynaud's. Better to see rheum or derm? How is it diagnosed?

Rheumatologist: As a dermatologist I diagnose raynaud's regularly. However, I always have my patients followed by a rheumatologist too. ...Read more

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My friend always has this rheum on his eyes. Now its bleeding. What is it? Please help me.

My friend always has this rheum on his eyes. Now its bleeding. What is it? Please help me.

Not sure: What you have asked is not clear. You should urge your friend to see a doctor. Rheum in this country usually has to do with connective tissue disease. If you are talking about a growth this should be seen and biopsied.
Best wishes. ...Read more

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I see my rheum in a couple weeks, but would having ssb antibodies cause problems even if lupus or other diseases weren't present?

See details: Positive ssb antibodies by themselves (when the ssa antibody is negative) have little clinical significance. They can be falsely positive. If the ANA and other tests for lupus are negative, I would disregard the ssb results. ...Read more

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Ana+ spec pattern 1:640. Rheum drs dismissed it. Elevated sed. Could it be cancer?

Ana+ spec pattern 1:640. Rheum drs dismissed it. Elevated sed. Could it be cancer?

NO: The diagnosis of lupus or other autoimmune disorders depend on satisfying a number of criteria. Many people will have mild elevation of ANA but not meet other criteria to make a diagnosis or not have enough symptoms to warrant immunosuppressive treatment which can also be dangerous or laden with side effects. The positive ANA is not a sign of cancer. Sed rate reflects an inflammatory condition. ...Read more

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If a rheum dr cannot diagnose me with a ANA + 1:640 speckled pattern should I be checked for cancer?

See another one: You should consider to see another rheumatologist for a second opinion. Look for a rheumatologist somewhere closer to you in a bigger institution/center. No, cancer is not associated with + ana. ...Read more

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With pos ANA jo-1 and pos rf but everything else neg but having myalgia can't get into seeing a rheum until feb should I worry?

With pos ANA jo-1 and pos rf but everything else neg but having myalgia can't get into seeing a rheum until feb should I worry?

Get Tests!: You only have these lab test. Worry only if your CPK and serum myoglobin are elevated. Treatment, if needed, can be done by someone in neurology, as well as rheumatology. Your myalgia very likely could be unrelated. ...Read more

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Can fibromyalgia feel like flu? I don't have pain, just the gross flu feeling all over, I get it often. Rheum. Doc thinks fibromyalgia after exams

Can fibromyalgia feel like flu? I don't have pain, just the gross flu feeling all over, I get it often. Rheum. Doc thinks fibromyalgia after exams

Then it likely is...: Absolutely! Your symptoms are VERY common amongst my FBS suffers. It is a complex syndrome that likely has multiple causes with similar presentation. There are MULTIPLE treatments but you will likely only find some of them to be helpful for you. I HIGHLY recommend that you seek out a Fellowship-trained Board-Certified Pain Medicine specialist who treats a LOT of FBS suffers. Do NOT go for opioids ...Read more

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My cardiolipin and RPR are normal but my drvvt came in high. I've had many symptoms of a rheum: immuno and neuro issues. What does this test mean?

My cardiolipin and RPR are normal but my drvvt came in high. I've had many symptoms of a rheum: immuno and neuro issues. What does this test mean?

See your doctor: You are obviously in the middle of a comprehensive work-up, and these test don't necessarily confirm a diagnosis by themselves, but are a part of the bigger picture which includes detailed history and physical exam. Discuss this and further options with your doctor. ...Read more

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1280 ANA, -ENA and compliments. Lupus symptoms, but rheum said no lupus because I have Blau Syndrome, rare autoinflammatory, doesn't cause ANA. Help!

Talk to your MD: Blau syndrome, systemic granulomatous syndrome, is a rare autoimmune disease affecting many organs. It can simulate, at least initially, other autoimmune diseases. There is effective treatment for most patients with the disease. Either talk with your rheumatologist or go to a tertiary medical center. ...Read more

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I'm 10 weeks postpartum with my 3rd child and I got a ra factor of 580 and ccp of 300. Is this severe? This is terrifying me! I made appt. With rheum.

I'm 10 weeks postpartum with my 3rd child and I got a ra factor of 580 and ccp of 300. Is this severe? This is terrifying me! I made appt. With rheum.

Don't B terrified-: -could B a false positive. But U R doing the right thing by making an appointment. Calm down, Bing terrified won't help @ all. What's 2 B will B. Wait until Ur appointment @ stay calm. U have enough 2 keep U busy with the baby. ...Read more

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Generalized body aches, malaise, depressed mood. Should I see rheum, psych, internal med?

Generalized body aches, malaise, depressed mood. Should I see rheum, psych, internal med?

Internal Medicine: Initially internal medicine - the differential here is quite broad. A lot more needs to be know and figured out before any decision for a specialty referral can be made. ...Read more

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If I have acute EBV infection wouldn't it show in cbc? My CBC normal but rheum states I have EBV infection presently.

If I have acute EBV infection wouldn't it show in cbc? My CBC normal but rheum states I have EBV infection presently.

Not necessarily: Ebv infection usually does not affect the CBC it may at times cause a slightly elevated white blood cell count but usually not. ...Read more

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I am 23, have sle with many organ involvement, & have not responded to any treatments my rheum. Has tried. Am I going to be okay?

I am 23, have sle with many organ involvement, & have not responded to any treatments my rheum. Has tried. Am I going to be okay?

Clarify diagnosis: There are many manifestations of lupus, but people with lupus are normal people who happen to have lupus. Some of your problems may not be lupus. On the other hand the first fda approved drug of lupus, in 50 + years is now available. In the correct setting the drug, Benlysta (belimumab) is a medication that may be indicated depending on the clarification of your diagnosis. We need to clarify. ...Read more

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RF/CCP neg My ANA is 1:320 but DNA neg and SM low at 10. My rheum suspected RA but now neg tests. So what now? Symp over 6 months are unbearable

RF/CCP neg My ANA is 1:320 but DNA neg and SM low at 10. My rheum suspected RA but now neg tests. So what now? Symp over 6 months are unbearable

Lab inaccurate: These types of blood tests are very inaccurate. Diagnosing RA is still dependent on the expertise of your doc not on lab. If you trust your doc follow their advice and don't rely on the lab. ...Read more

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ANA done and it was 1:320 finely speckled. The rheum said that the speckled part isn't good indicator of lupus and there is another way to do ANA??

Other tests: ANA not specific. Other tests are anti-sm, considered specific; high titre anti_ds DNA considered specific. There are many other less specific autoantibodues. ...Read more

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Please help. Is pmr a medical emergency if 79 y/o cannot get out of bed d/t stiffness and pain? His sed rate is 113. His first rheum appt is monday.

Please help. Is pmr a medical emergency if 79 y/o cannot get out of bed d/t stiffness and pain? His sed rate is 113. His first rheum appt is monday.

Yes!: This much inflammation poses serious cardiovascular and stroke risks. A high ESR means high clotting factors. Polymyalgia is serious rheumatic disease, alone. See a rheumatology specialist, if you can. ...Read more

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Why do pcps tend to run direct ANA and rheum mds run ANA titers? Should pcps be running the titer instead when suspecting autoimmune condition?

Ana: Difference usually pcp screening for disease where rheumatology looking for severity of disease or following disease activity. Personally I order with reflex to titter. ...Read more

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Doc suspects SLE or AIH. Can u help prepare a checklist before visiting Rheum for symptoms of SLE and AIH, bloodworks & questions he may ask me?

Doc suspects SLE or AIH. Can u help prepare a checklist before visiting Rheum for symptoms of SLE and AIH, bloodworks & questions he may ask me?

See details.: The distinction should not be all that difficult. Lupus is not assoctiated with liver inflammation. If AIH is suspected, a liver biopsy should confirm the diagnosis. Also, certain autoantibodies can differentiate. Forget the ANA, it is positive in both diseases. ...Read more

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I am on MTX & feel like all I am doing is complaining to my Rheum about the side effects. My cheek is twitching. Is that serious enough to tell her?

I am on MTX & feel like all I am doing is complaining to my Rheum about the side effects. My cheek is twitching. Is that serious enough to tell her?

Neuropathy: From Methotrexate can cause focal muscle twitching and numbness. Have your Rheumatologist check you for neuropathy or better yet have her send you to a neurologist who can perform a nerve conduction test. I recently had a patient develop polyneuropathy on MTX for Psoriatic arthritis. He was switched to Embrel (Enanercept) and the neuropathy resolved (as did his skin lesions and arthritic pain) ...Read more

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