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Can Plaquenil Be Taken For Borderline Rheumatic Conditions?
Question: Hi.....my rheumatoid factor just 14....but my ana is 1:1280. my crp, anti ccp, lupus anticariolipin antibodies,
direct coombs, beta-2, antihithyroglobulin, antithyroid peroxidase, rpr,hepatitis and sjogrens are normal. I did just find out that I have polycythemia vera with Jak2 mutation from hematoligist and will be starting phloebotomy this week. The rheumotologist mentioned Plaquenil for my borderline Rheum factor but in light of the fact that I have no other symptoms and other key tests were negative I would like to hold off starting plaquenil until I get the pcv under control. Is this a big mistake? He let me postpone 1 mo. so far
direct coombs, beta-2, antihithyroglobulin, antithyroid peroxidase, rpr,hepatitis and sjogrens are normal. I did just find out that I have polycythemia vera with Jak2 mutation from hematoligist and will be starting phloebotomy this week. The rheumotologist mentioned Plaquenil for my borderline Rheum factor but in light of the fact that I have no other symptoms and other key tests were negative I would like to hold off starting plaquenil until I get the pcv under control. Is this a big mistake? He let me postpone 1 mo. so far
Brief Answer:
Starting plaquenil
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, firstly I would like to know why you underwent all these tests are they are all related to autoimmunity. So did you have any symptoms for it or was it routinely tested?
2. Plaquenil is mainly for your Strong ANA. I am not sure why they mentioned Rheumatoid FActor as it is only 14( normal cut off being 12) and 14 can be expected in elderly age. But the ANA is quite strongly positive at 1: 1280. But the good part is the further tests are all negative. Plaquenil just helps in slowing further conversion/progression of ANA. So all the more, I would like to know your symptoms to see if it fits into the disease.
3. Plaquenil is a safe drug to take. You can take it along with your phlebotomy also without causing much of a problem..The action of the drug takes around 3-4 months, so I would suggest not to delay it too much as longer we do, longer the time of action. But if you asymptomatic, we can still wait around.
But do let me know your symptoms so I can guide you further if you should start now or we can still wait..
Await your reply
Regards
Dr Naval
Starting plaquenil
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, firstly I would like to know why you underwent all these tests are they are all related to autoimmunity. So did you have any symptoms for it or was it routinely tested?
2. Plaquenil is mainly for your Strong ANA. I am not sure why they mentioned Rheumatoid FActor as it is only 14( normal cut off being 12) and 14 can be expected in elderly age. But the ANA is quite strongly positive at 1: 1280. But the good part is the further tests are all negative. Plaquenil just helps in slowing further conversion/progression of ANA. So all the more, I would like to know your symptoms to see if it fits into the disease.
3. Plaquenil is a safe drug to take. You can take it along with your phlebotomy also without causing much of a problem..The action of the drug takes around 3-4 months, so I would suggest not to delay it too much as longer we do, longer the time of action. But if you asymptomatic, we can still wait around.
But do let me know your symptoms so I can guide you further if you should start now or we can still wait..
Await your reply
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The funny thing is there are absolutely no symptoms.....this was my routine blood test that set this off....seeing rheum for the ANA and i guess high platelets...seeing the hematologist for high platelets and red blood cells and the Jak2 came back positive for mutation...so just doing phloebotomy
My ana has been a little high for years....usually 1:80 but big jump to 1:1280..my platelets have always been in the 500s.....now went from 600 to 700 in the last month and a half...
My aunt had lupus but those tests came out negative....its strange. I wonder if allergy to hair XXXXXXX use 1 x month can set off ANA? This is a great service and I appreciate your help..having trouble sorting both of these things out.
My ana has been a little high for years....usually 1:80 but big jump to 1:1280..my platelets have always been in the 500s.....now went from 600 to 700 in the last month and a half...
My aunt had lupus but those tests came out negative....its strange. I wonder if allergy to hair XXXXXXX use 1 x month can set off ANA? This is a great service and I appreciate your help..having trouble sorting both of these things out.
Brief Answer:
Further queries
Detailed Answer:
Good evening
1. The rise in platelets can be a part of Polycythemia itself as the thrombocytosis (Increased platelets) can be due to your JAK 2 mutation. They all belong to the same family and stimulation in one cell line can stimulate the other as well. It will respond to phlebotomy
2. Well, if you have no symptoms you can wait on PLaquenil. The jump in ANA can be false as well due to your polycythemia. ANA is not a very sensitive marker, so it can be falsely raised in a lot of condition.
I would suggest--> you undergo your treatment for polycythemia for a month and then repeat your ANA. If it is still high, then you can consider starting PLaquenil. If it improves, we can wait on it. Cause once the drug starts, it is hard to stop it for simple concern of fear. So, we can be a bit cautious before putting you on it.
Hope the information was useful
Do let me know for more queries. WOuld be happy to help out
Regards
Dr Naval
Further queries
Detailed Answer:
Good evening
1. The rise in platelets can be a part of Polycythemia itself as the thrombocytosis (Increased platelets) can be due to your JAK 2 mutation. They all belong to the same family and stimulation in one cell line can stimulate the other as well. It will respond to phlebotomy
2. Well, if you have no symptoms you can wait on PLaquenil. The jump in ANA can be false as well due to your polycythemia. ANA is not a very sensitive marker, so it can be falsely raised in a lot of condition.
I would suggest--> you undergo your treatment for polycythemia for a month and then repeat your ANA. If it is still high, then you can consider starting PLaquenil. If it improves, we can wait on it. Cause once the drug starts, it is hard to stop it for simple concern of fear. So, we can be a bit cautious before putting you on it.
Hope the information was useful
Do let me know for more queries. WOuld be happy to help out
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
you are awesome
Brief Answer:
Further query
Detailed Answer:
I am glad I could be of some assistance :)
Regards
Dr Naval
Further query
Detailed Answer:
I am glad I could be of some assistance :)
Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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