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THE Q & A
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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.
Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.
Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.
Copying of any posts is prohibited without permissions.
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Notice: No notices today.
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| paperbagprincess |
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Joined: 3/17/2012
Posts: 1
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I'm 22 years old and have had symptoms of something since I was a child. I was diagnosed with synovitis/arthritis when I was 8. Since then I've had symptoms of dry mouth/dry eyes, joint pain/morning stiffness/mild swelling, fatigue, urticaria and vascular rashes, sun sensitivity, mouth and nose ulcers, Raynaud's, nail pitting and the list goes on.
My blood tests are negative for everything. My ANA was positive at 1:80, but I moved cities and my current lab reports anything under 1:320 as negative, and mine is now negative. I have had very thorough lab testing, a lip biopsy for Sjogren's, everything is normal. My Schirmer and rapid tear break up confirms my dry eyes, my saliva flow test shows a very dry mouth. A bone scan showed mild uptake in my wrists, fingers, sacroiliac joints, knees and shoulders. My ESR and CRP are normal.
My rheumatologist once committed to "you either have Sjogren's or Lupus and the blood tests will develop in the years to come". She prescribed me Hydroxychloroquine/Plaquenil 6 months ago. At my last appointment she changed her mind and said I didn't have an autoimmune disease, nothing was wrong with me and got quite angry with me. But despite this, she told me I could stay on Plaquenil.
In the past 3 weeks I've noticed a dramatic improvement in my joints and fatigue. My nose and mouth ulcers have almost all gone.
If I had nothing wrong with me, no autoimmune disease, would I experience this improvement from the Plaquenil?
And how often do the blood tests show up years after the symptoms begin?
Thank you.
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| Elaine |
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Joined: 8/1/2008
Posts: 3424
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Hi,
In Sjogren's, the ANA can be negative and you can still have a positive SSa (Ro) antibody test. See my article on the SSa test either here or on suite101. I hoped your rheumy tested for SSa and SSb. From what you're describing, you may meet the diagnostic criteria for Sjogren's even without a positive ANA.
I'm surprised by your lab regarding results below 1:320 as negative as most studies show that 1:160 results are generally true positives. Usually, antibody test results are positive before symptoms show up although if you have low immunoglobulin levels, your antibody titers can remain low or negative. I'd probably see a different rheumatologist unless this one continues to prescribe Plaquenil and you're happy with this.
Here's the diagnostic criteria for Sjogren's and as you can see a positive ANA isn't required although you should test positive for either SSa or SSb. Usually, SSa is seen. Most people do not feel better on Plaquenil if it's not needed--in fact, they complain about side effects. best, elaine
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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.
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