I am a 46 year old female. I have had a diagnosis of endometriosis, and ended up with a total hysterectomy when I was 41. I recently had a positive ANA test, 1:320 with homogenous pattern. This was done to see why I have had such problems with joint pain and arthritis. I have dry eyes (punctal plugs in place), chronic sinusitis, fatigue, night sweats, GERD, depression and of course, the arthritis. I have seen a Rheumatologist who has said that I don't have lupus or rheumatoid arthritis, but rather osteoarthritis. He is doing some more bloodwork on the lupus issue, but I don't have the results yet. With all of this said, would I be better off seeking an immunologist? What is the difference between the immunologist and rheum.? OR do I just accept his diagnosis and go on? :confused:

I may be wrong, but I am thinking that an immunologist deals mainly with allergies/hypersensitivities and a rheumatologist treats joint/connective tissue diseases.

Actually, I think that you're probably right. So the only specialist for immune disorders is a rheumatologist?

Yep, afraid so. A good internist can treat it, but most won't. I wish mine would, but he insists that I need a specialist.....

While I treat with my Rheumatolgist routinely twice a year, I routinely treat with my Integrative MD, who specializes in Immune disorders on a regular basis. I find that this works well in controlling or keeping my Lupus at bay. :wave:

Hi,

Your question is a good one, and I wish I knew the answer myself... Please see Hewie's posts in the thread "Should I see an immunologist..." for her interesting comments.

Just on a "gut" level, I suspect that you should be seeing a rheumatologist, but I am not sure that the one you have been seeing is necessarily being as thorough as he could be in ruling out the many other rheum. disorders that you could have. To my knowledge (just as a layperson), osteoarthritis by itself would not cause an elevated ANA.

There's also the issue of your dry eyes -- what about Sjogren's?

For what it's worth, I just read a few days ago that endometriosis can be autoimmune in nature; with that in mind, the possibility increases that, if that was the case with you, you might have another autoimmune disorder that is behind your current symptoms.

Please give some thought to finding another rheumy. The best of luck to you! :)

:cool: Thanks to everyone who responded to my plea for help! I am (once again) seeing my Internal Med. doctor on Friday. I am hoping for a referral to a different, and more experienced Rheum. I'll keep you posted!!

Does anyone else have large reactions to insect bites? :confused: I was bitten by an Asian lady beetle, and the swelling and itching have been unbelievable. I also react to mosquito bites in about the same way.

LZ

Well, that was quick work! Good luck on extracting that referral out of your internist; don't be shy about explaining that you weren't "completely confident in Dr. So-and-So's ability to explore all of the possible factors that might be at the root of" your symptoms and that you "feel as though "another opinion" is warranted at this point." Don't pull any punches -- this is your health at stake here, and not your PCP's!!! :rolleyes:

Sorry that I can't help you out with your welts. In my experience, some people just seem to be prone to more serious reactions than usual to insect bites. My sister is like that with "black flies", and a friend's son has violent reactions to mosquitoes (even his lymph nodes nearest the bites swell up), especially to any bites on his face or neck.

Given your tendency to extreme reactions, at the first sign of an itch (if you've been outside recently, that is!), load up on Benadryl. (But obviously ask your doctor about this in advance!)

Good luck on Friday. :) Keep us posted!!!!

Best,
Pat

okay i have something to say here.. i was sent to an immunologist .. i have autoimmune issues ..the only thing he seems to be address is my so called allergies and sinusitis... i am now going to have to see an rheume.. so if your suffering autoimmune issues .. i would pick rheume.. i had to wait 8 weeks to see the immunologist then a 6 week followup and i am now going to have to wait to see the next doctor.. my gp said ..he didn't address your joint or sysemtemic issues.. :rolleyes:

OK was just at the immunologist and i take some of what i said back.. last time i had a terrible resident. it iwas a teaching hospital.. so the new res.. re did my history and i had a positve ana test so he took me much more seriously this time.. but i think i really need a rheume..LOL

There are some Autoimmune disorders that GI doctors also treat. I have Sjorgrens and Autoimmune Hepatitis and I am being treated by GI doctors for this. I think it's because the Autoimmune hep affects the whole GI tract besides the liver.