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Got over from pneumonia. Having Aphasia and dizziness. Scan report show groin hernia. Showing symptoms of paraneoplastic syndrome. Help?

Jun 2013
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Practicing since : 2005
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my husband has a positive XXXXXXX and a positive anti-dna (ds) and no symptoms of Lupus or MS he just got over pneumonia and has some neurological issues going on like Aphasia and alot of dizziness that wakes him up in the middle of sleeping which is really bizarre it is very scary and he has already had a MRI and 3 CT-Scans but he has what looks like a groin hernia that i am afraid is lymphoma because of everything going on it is the one thing that everything points to but the Ultrasound on the hernia confirms no enlarged lymph nodes but I know it could be a misdiagnosis. He is 62 yrs. old. and has sub-centimeter spots on the lungs and in the brain but they said they are too small to worry about now just watch them. Mean while his dizziness is constant and we can't wait we need to do something about finding out what is going on before it is too late! Can you help? Everything I read about on a positive anti-dna says Lupus or MS but he has no symptoms of either however he is obviously having some kind of autoimmune problem and everything I read about his symptoms brings me to Lymphoma but the only lumps he has is a double hernia that is growing and I know that is a spot where Lymphoma could show up at. Also he has several symptoms of paraneoplastic syndrome but that is usually diagnosed after cancer has already been found but hey I don't now what's going on with him just that something is and everybody likes to avoid the issue of Cancer But I have more fear of ignoring it since everyone in my husband's family has died of it. I know it is a possibility! His primary care Dr. said he has Mixed Connective Tissue Disease but Does Not have any of the specific symptoms so I guess she is just basing it on the positive anti-dna. Can you help? Please get back to me asap! Thank You XXXXXXX Facteau ( YYYY@YYYY )
Posted Thu, 20 Jun 2013 in Lupus
Answered by Dr. Sushil Kumar Sompur 10 hours later
Hi there ~

I understand your concerns for your husband and the brief history that you have provided here. I hope your husband is better with the pneumonia at the present time. I also am glad that he is lost weight for health reasons, however losing more than 10% body weight over a period of one month may not be healthy and might need more medical attention. Dizziness can be a result of dehydration or a deficiency in the autonomic system which you relate, and may be related to his having the autoimmune condition. I am glad that your husband does not smoke, as this is one modifiable condition that you have out of the way, good for you and your husband.

An XXXXXXX test detects antinuclear antibodies in your blood. Your immune system normally makes antibodies to help you fight infection. In contrast, antinuclear antibodies often attack your body's own tissues — specifically targeting each cell's nucleus.

In most cases, a positive XXXXXXX test indicates that your immune system has launched a misdirected attack on your own tissue — in other words, an autoimmune reaction. But some people have positive XXXXXXX tests even when they're healthy.

Your doctor may order an XXXXXXX test if he or she suspects you have an autoimmune disease such as lupus, rheumatoid arthritis or scleroderma. The presence of any antinuclear antibodies is a positive test result. But having a positive result doesn't mean you have a disease. Many people with no disease have positive XXXXXXX tests — particularly women older than 65.

Mononucleosis is one type of infection that has been associated with the development of antinuclear antibodies. Some blood pressure lowering drugs and certain anti-seizure medications may trigger antinuclear antibody formation as well.

If your doctor suspects you have an autoimmune disease, he or she is likely to order a number of tests. The result of your XXXXXXX test is one piece of information your doctor can use to help determine the cause of your signs and symptoms.

Double-stranded (ds, native) DNA (dsDNA) antibodies of the IgG class are an accepted criterion (American College of Rheumatology) for the diagnosis of systemic lupus erythematosus (SLE). dsDNA antibodies are detectable in approximately 85% of patients with untreated SLE, and are rarely detectable in other connective tissue diseases. Weakly-positive results caused by low-avidity antibodies to dsDNA are not specific for SLE and can occur in a variety of diseases.

Testing for IgG antibodies to dsDNA is indicated in patients who have a positive test for antinuclear antibodies (ANA) along with signs and symptoms that are compatible with the diagnosis of SLE. If the XXXXXXX test is negative, there is no reason to test for antibodies to dsDNA.

The levels of IgG antibodies to dsDNA in serum are known to fluctuate with disease activity in lupus erythematosus, often increasing prior to an increase in inflammation and decreasing in response to therapy.

There is currently no cure for systemic lupus erythematosus (SLE). However, treatments are available that can help ease your symptoms and minimise the effect the condition has on your daily life.

Protecting yourself from the sun.

Some medicines you may need if you have SLE are described below.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Commonly prescribed NSAIDs for SLE include:

You will usually have to take hydroxychloroquine for 6–12 weeks before you notice any benefit.

Corticosteroids are a type of medicine that help reduce inflammation quickly. They are very effective but usually only prescribed if you have severe SLE.
If you have severe symptoms of SLE, or if you are experiencing a flare-up, you may be given a large dose of corticosteroids to help bring your symptoms under control. As your symptoms ease, your dosage can gradually be reduced.
When prescribing corticosteroids, the lowest effective dosage is always given. This is because high doses or long-term use of corticosteroids can cause side effects. These may include:
thinning of your bones
thinning of your skin
weight gain
high blood pressure (hypertension)
Corticosteroids are a safe and effective form of treatment provided they are taken correctly and under the supervision of your GP or specialist. They will tailor the steroid dose to your disease activity to minimise side effects while effectively controlling the condition.

Immunosuppressants are a type of medicine that suppress your immune system. They can help improve your symptoms of SLE by limiting the damage your immune system causes when it attacks healthy parts of your body.
Commonly prescribed immunosuppressant medicines include:
mycophenolate mofetil

Immunosuppressant medication is usually only prescribed if you have severe SLE. This is because this type of medication is very powerful and can cause side effects such as:
loss of appetite
swollen gums
bruising or bleeding more easily
extra hair growth
weight gain

Suppressing your immune system increases your risk of developing infections. Immunosuppressants can also sometimes cause liver damage. For these reasons, you will need regular check-ups and blood tests when taking immunosuppressant medication.
Report any symptoms of an infection to your GP immediately, because you may need prompt treatment to prevent serious complications.

Your husband seems to have REM sleep behavior disorder (RSBD) which is very common and it can be cured with medications. I hope you visit with a sleep specialist for the same - to run investigations and prescribe medications. Using long acting sedatives will improve his sleep patterns.

I hope this helps.

Take care and have a lovely day!

Above answer was peer-reviewed by
Follow-up: Got over from pneumonia. Having Aphasia and dizziness. Scan report show groin hernia. Showing symptoms of paraneoplastic syndrome. Help? 9 hours later
Thank you for your response but apparently you really didn't understand my concerns because saying that you were glad my husband lost weight for health reasons were completely contradictory to what I have written. My husband is a 6ft 2in very skinny man who normally weighs about 165lbs and was down to 138 he was extremely under weight and had lost it farely quickly so when he got his pneumonia I was very concerned so he Needed to gain weight Not lose it!! The other thing is I was asking about an opinion on a positive XXXXXXX and a positive anti-DNA (ds) with NO symptoms of Lupus and you told me everything I already know on the subject he is not dehydrated and so that is not why he is dizzy! Dizziness is Not a symptom of Lupus among all the symptoms that is not one! I also wrote about him having Aphasia and I know it is a neurological problem so he is between a CNS disorder and a autoimmune disorder that doesn't fall in any specific catagory and I wonder how you got a hold of my question when you are a psychiatrist and I asked for a Rheumatologist that is who could best answer my concerns or an oncologist who specializes in Rheumatoligy problems. I mean I am talking about a man who's whole family has died of cancer so he is at risk and he has had lung issues with the pneumonia there is still a small spot being watched and cross this with his huge hernia they say isn't an enlarged lymph node and it could Very well be but needs to be examined under a microscope to know for sure so he could very well have Lymphoma and that would explain it all the positive XXXXXXX frequently can be cancer and the dizziness and the weight loss and lung cancer can spread to the brain and that would explain his Aphasia so I hope not but that is why I'm on here to make sure that if there is any way it is cancer then he needs treatment before it is too late!
Answered by Dr. Sushil Kumar Sompur 17 hours later
Hi there ~

I am sorry that I was misunderstood by you. You did not mention that your husband was tall and I thought that you were mentioning in his history that he is "pretty healthy until the pneumonia a few months ago and lost alot of weight now that is all better he is still very fatigued all the time and very dizzy!". I have just taken that from your own description. Thank you for clarifying that you are not very happy with the weight loss and I am sorry for that.

I am sorry you selected the wrong category as you yourself mention that he does not fit either a doctor for lupus or a doctor for dizziness. For your clarification an oncologist does not specialize in rheumatology problems. What you might really need is a geneticist, who can tell you for sure after taking samples from different parts of his body whether he has cancer or not. For all that you might just be anxious about something that is a treatable condition. I hope this helps. Take care and have a lovely day!
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