Hi! I went to my doctor on Friday due to bilateral pain/swelling/stiffness in the joints of my fingers (15 joints in fingers, none being the joint closest to the fingertip), my wrists, my knees, and my ankles. (I was mostly worried about the hands. I can live with leg pain, but I have a nearly 6 month old, and I have to be able to hold her, and I was starting to have severe weakness in the finger joints. Made the appointment when I nearly dropped her.) He gave me diclofenac 75mg 2x daily, and that is helping a good bit. I still hurt, but it's much less.
He took a few vials of blood, and called me this morning saying I have an AI disease, his guess is RA but he's not a rheumatologist so he doesn't want to diagnose for sure, and get an appointment ASAP.
I've got my blood test results in front of me, and I wish I understood what they all mean, and what they all point to? So I was hoping someone here, smarter than me, could help.
ANA Direct - Positive
Anti-DNA (DS) AB QN Result 1 Range 0-9 Negative
Antistreptolysin O AB Result 259.2 Range 0.0-200.0 High
RA Latex Turbid Result 19.8 Range 0.0-13.9 High
Sedimentation rate - Westergren 32. (There is no range listed on there... but if Wiki isn't lying to me, my base rate should be 21? I'm a 32 year old woman.)
My CBC he ran at the same time looked almost perfectly normal, only one high or low in any way was MCH, and I'm only "low" by 0.1 so I doubt that matters much?
Can anyone tell me what those results really mean? My doctor basically just says "that means you have an AI disease, talk to a rheumatologist" and I can't get into one for over a month. I just want to know what I'm dealing with so I can get my research on and know how to help myself. I'd assume RA given blood results and symptoms, but I'm not sure what the ASO test means, and... yeah. Just help? Please?
The ASO is an antistreptolysin test that means, when elevated that you have had a recent strept infection, usually strept throat, which can lead to rheumatic fever, an immune reaction to the strept that causes joint pain, inflammation, fever, and sometimes heart and kidney problems. It is important, I think, to have a strept culture of throat done, to rule out current infection, as strept should be treated to eradicate it, if there is any chance of rheumatic fever. That said, with lots of other antibodies positive, the ASO could be a false positive, and your immune system is just overproducing antibodies to substances you have been exposed to in past. The ANA is a test for lupus, and this "positive" test should be followed up with a titer, which helps determine how positive it is. The sed rate should not be over 20 in women, so that reflects excess inflammation in your body, which is causing the joint pains. The RA factor being elevated, indicates RA could be the culprit, but your clinical picture is not clear cut at this point. The rheumatologist will want to do some additional tests to try to narrow it down, and some people have what appears to be a mixture of different autoimmune diseases, called mixed connective tissue disease. The DNA being negative is good, as that is associated with a higher likelihood of kidney disease in people with lupus, as some get it and others do not. At this point, I would just ask your Dr. to do a strept culture, and of course treat it if positive, or if you remember having a bad sore throat in the last month or so that wasn't treated. Strept can be harbored in the tonsils without symptoms in a low grade infection. Then you can also ask to be put on the cancellation list to get in sooner, or get another rheum name from your Dr who might be able to see you sooner. Be prepared for not getting a specific diagnosis for awhile, as rheums rarely commit to naming a diagnosis early on especially when there are several positive tests showing up. Good luck and please keep us posted.
Ladybug is right, everything she said is relevant and makes sense.
Often people think if their joints swollen and they got pain in them, it means they have RA. Not necessarily.
Like she said, simple strep may give you this type blood work results; AI may be Lyme, sometimes Mono (with some differences), Epstein Bar and more.
Did you hear about people with strep when they don't have pain with it? They have the worst case scenario since they don't have symptoms so they don't go to see a DR, meanwhile they as contagious as people with painful symptoms. And the worst part, it can become "chronic" causing heart damage.
So do yourself and your sweet baby a favor, get a very good examination and be under good doctor's care. If you see he dismisses you while you still have your symptoms, look for someone better. Unfortunately very hard to find a good doctor sometimes, so don't get discouraged.