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Kayfarooq
Kayfarooq, Board Certified Physician
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Experience:  MB;BS
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My blood test indicated a positive ANA Screen, IFA as well

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My blood test indicated a positive ANA Screen, IFA as well as Anti-Nuclear AB Titer 1:320 with a Nucleolar ANA Pattern. I went to Rheumy complaining of joint pain in knees and morning stiffness in ankles, toes and hands with overall fatigue. HE said the blood work didn't mean anything and is often seen in healthy individuals. Since then I am experiencing nasal sores that wont go away. I am about to schedule an appointment to have the nasal sore which is on the inside lateral part of my nose just inside the opening on the membrane. I am looking for a second opinion on these issues.

Regards,

XXXXX XXXXX
Submitted: 3 years ago.
Category: Medical
Expert:  Kayfarooq replied 3 years ago.

Kayfarooq :

Hello there. How long have you been having these symptoms? Can you quantify their severity on a scale between 1 to 10 (like from being perfectly normal to complete disability? Regards

Customer: replied 3 years ago.
Four to Six months ago I had moderate to severe fatigue with difficulty climbing the stairs to my bedroom on second floor about 12 stairs. I was diagnosed with Fybromyalgia before blood work was done I felt aches all over but the fatigue was the worst of it. On a scale from 1 to 10, I was an 8.

Now the fatigue is much better but the joint pain is a 7 and this nasal sore is very painful and just wont go away. I am keeping it clean daily with Hydro-peroxide swab it is white and hard with a sore inflammed redness around it, it doesn't seem to be infected I see no yellowness or puss. My allergies were bad and I thought it was from that but allergies cleared up and nsal sore stayed. I also take Valtrex for Genital herpes outbreaks. I have not had any outbreaks recently and do not take the meds daily. Hope this information is helpful.

Kim
Expert:  Kayfarooq replied 3 years ago.
Thanks a lot for the answer. There are some doubts about these tests particularly with increasing age. To label with an autoimmune disease needs a lot of evidence so your doctor might be taking it as insufficient. As you have other inflammatory problems going on, these values become even less important as their standing for RA. Inflammatory illnesses in older age makes these values positive. 1:320 is positive but not a sky high value for a diagnosis.

But you still can go for further testing and a second opinion from another clinician with a clinical examination in person would be very much helpful.

I recommend you to get another evaluation, which should be done in view of your symptoms, parallel medical problems and progress recently.

Feel free to ask anymore questions in this regard. I am here for your satisfaction.
Best Regards
Customer: replied 3 years ago.
I take my recent progress in the fatigue department to be due to the fact that I am unemployed and can stay at home and rest as needed. Stress agravates my fatugue symptoms and sleep and relaxation improves it.

I don't understand this part of your answer, "There are some doubts about these tests particularly with increasing age." Does increasing age invalidate test results in the case of RA? How much joint inflammation is considered normal for a 50 year old? I guess the doctors don't practice the "If it walks and talks like a duck, its probably a duck guidline. I guess it depends on the doctor. I have been ill a long time, many years and have seen lots of doctors but this is first RA.

You didn't mention the painful nasal sores and what they might mean or be caused by. Is Lupus or Chrones disease a consideration? My Lupus Antigoag Eval with RFL was not detected. Can you still have mild Lupus with this result? I also have bouts with IBD and take OTC for Gerd. There is a lot going on with me physically.

Thanks.
Expert:  Kayfarooq replied 3 years ago.
Increasing age is associated with increased inflammatory activity in a generalized way. So it is associated with increased number of false positive results. I think a follow up test after two months will be important to make a diagnosis. It will also determine the serum titre increasing or decreasing tendency. A simple positive test is usually not enough to make diagnosis. For lupus, the only thing that can be said with certainty is that it should be reviewed after few weeks.
Kayfarooq, Board Certified Physician
Category: Medical
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Experience: MB;BS
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