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Dr. Anil
Dr. Anil, Doctor (MD)
Category: Health
Satisfied Customers: 8824
Experience:  M.B.B.S.M.D with over 30 years of experience in this medical field.
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My daughter is 13 years old. She had some lab work done last

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My daughter is 13 years old. She had some lab work done last week, including a urinalysis. It showed she had a very bad UTI and a positive RA factor, but all other labs came back fine? I am very scared for her. I, myself have been diagnosed with SLE and scleroderma about 10 years ago!!

Hello,

What are her current symptoms?

Which medications is she taking?

Since how long has she been suffering from?

 

 

Thanks.

Customer: replied 3 years ago.

She has been hurting in her left shoulder blade for over 4 months. She has been seeing a chiropractor all summer. She had 4 MRI's done and found cyst on her shoulder and spinal cord. She is currently taking Ibuprofen 800 mg, baclofen 10mg, famotidine 20 mg, and an antibiotic for the UTI. Unexplained weight loss as well. She has lost 15 lbs. since last fall


 

Hello,
Thanks for providing more information.
Firstly cyst in shoulder can result in pain in shoulder blade.

However as she has positive RA factor so this itself alone doesn't indicate Rheumatoid arthritis.

Positive RF test results may also be seen in healthy people and also in people with kidney disorders.

 

Further blood work like Quantitative RA factor, HLA-B27 test, ANA, CRP, Anti-CCP, ESR should be done to rule out Autoimmune disorder.

As she has family history of SLE so risk of getting auto immune disease are high as it can be hereditary/genetic.

Rheumatoid factor may also be elevated in chronic hepatitis, any chronic viral infection, dermatomyositis, infectious mononucleosis, systemic sclerosis apart from systemic lupus erythematosus (SLE).

So further a referral to Rheumatologist should be considered.

And if it is initial stage then it can be treated well rather than considering wait & watch approach.

 



I hope this helps.
If you have any further query then feel free to ask.
Positive feedback and bonus are highly appreciated.
Thank you.

Customer: replied 3 years ago.

She is being scheduled for an MRI with contrast. She had a lot of other blood work done and it all came back good (including ANA, CBC, CCP). Would a repeat of the blood work be beneficial?

Hello,
Thanks for the follow-up.
MRI with contrast can help in detecting Autoimmune disease like Rheumatoid arthritis(RA) to see if there is associated changes in shoulder due to RA.
RF and Anti-CCP are marker of RA.
Neither one have to be present to make that diagnosis.
In the general population about 5% of the people without RA have a positive RF, and less than 5% have Anti-CCP.

Other tests include HLA-B27, Complement tests, and cryogloblulins to rule out autoimmune disorders should be done in her case.
So a referral to Rheumatologist should be considered as well.

I hope this helps.
If you have any further query then feel free to ask.
Positive feedback and bonus are highly appreciated.
Thank you.
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