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Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions?

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General & Family Physician
Practicing since : 2006
Answered : 567 Questions
I showed positive on a nuclear antibody test. SS-B bioplex was pos. I am in the sun quite often so I ruled out lupus. The Doc at the Naval Hospital Jacksonvilke Fl viewed my labs and told me to get checked for hemochromatosis. My primary care doctor ordered tests that the VA did not give me. Can you tell me what specialist I need to go to. My VA Doc hasn't returned my calls in past 2 mos, and my family practice Doc said this was over his head. Hes in his late 70's and he doesn't always make sense. Could you tell me what you think of my lab results please and tell me what type of specialist I need to make a consult with? I had my left leg amputated in the U.S Navy several years ago, and I am trying to do everything healthy between lifting weights 6 times per wk and running on my new prosthetic a few miles a week, and eating healthy, and no drugs or booze. I feel awful every morning I wake up. I am always so fatigued and lethargic, and my Doctors think I am exagerating because I am in good shape, but I've been feeling like this for past 2 yrs. Can you please give me some advice. I am 6'3" and 225lbs and 39yrs old. I have Tricare and Medicare ins, so I can see any Doc and not have to pay a copayment.
Serum SS-B Bioplex. Positive
Serum XXXXXXX Screen Bioplex. Positive
Iron 232 UG/DL. TIBC 327 ug/dl
Transferrin Sat% 71% Ferritin. 246
UIBC. 95 UG/DL Cholesterol 180 MG/DL
GFR. 56 ml/min. Glucose 82 MG/DL
BUN/CR RATIO 14. Potassium 5.1 MMOL/L
Sodium 141 MMOL/L. Chloride. 102 MMOL/L
Carbon Dioxide. 28. MMOL/L ANION GAP 16Meg/L
Total Protein. 7.4 G/DL. Albumin. 4.5 G/DL
Globulin. 2.9 G/DL. A/G Ratio 1.6
Hepatitis A, B, & C. Non-Reac
Hepatitis B SURF.AG. Negative
HIV 1&2 Antibody Screen Nonreactive
Posted Sat, 24 Aug 2013 in Lupus
Answered by Dr. Jay Patel 6 hours later

I am dr XXXXXXX and I will try my level best to address your concern.

I went through your entire blood report as well as your history and I found two abnormalities that needs to be addressed.

1) You are SS-B Bioplex-Positive which makes you LUPUS PATIENT
2) GFR IS 56 ml/min which indicates a chronic (long term) kidney disease may be due to lupus.

I would like you to consult " NEPHROLOGIST" and make sure you asked if they treat patient with may be lupus related kidney issues.


Now about the issue of feeling of low energy/ fatigue and tiredness - as far as low energy is concern I believe in you that you will have such issue due to a long term intake of "NEURONTIN " will develop it. Its known side effect of neurontin. For addressing it your physician need to change that medication if possible.

Hope my answer is able to satisfy your current needs.

Thanks for the query, and feel free to contact me in case of further concern.

Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 7 minutes later

I stay in the Sun all year long in Florida. I have very XXXXXXX skin, and I don't burn easily. I thought that people with lupus can not tolerate long term exposure to direct sunlight.

One of the Doctors that is in charge of the laboratory at the Naval Hospital thinks it possibly might be Hemochromatosis(Iron Overload). Do you think that is possibile with my high iron levels?
Answered by Dr. Jay Patel 22 minutes later

welcome back, its not essential that not able to tolerate direct sunlight is seen in 100% cases, so your's might be an exception, more over you are positive for the Serum SS-B Bioplex as well as Serum XXXXXXX Screen Bioplex. Which does put you in as may be LUPUS case.


Sorry I Over looked some iron levels

Now the TIBC is Iron-binding capacity, total, serum — 250-460 µg/dL normal range yours is 327 ug/dl which still in normal range.
Iron, serum — 60-160 µg/dL (11-29 µmol/L) : yours is Iron 232 µg/dL high
Ferritin, serum — 15-200 ng/mL (15-200 µg/L) : yours is 246 high
Transferrin saturation — 20%-50% : yours is 71%. high

So all in all it does make a good case for the Hemochromatosis(Iron Overload). I would like you to consult - "Enterogastrologist " as well as "Nephrologist". Please have it checked.

Let me know if I could be of any other help.

Thanks again.
Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 7 hours later
Please forgive me Sir, but what are you referring to by """ thar you wrote?
Answered by Dr. Jay Patel 6 hours later
Hello sir,

Welcome back, sorry I was not clear in previous answer.

Here is what i meant, there are "KIDNEY ISSUES" looking at the GFR rate, now for that there may be two possibilities

1) Kidney issues secondary due to LUPUS

2) Kidney issues secondary due to Hemochromatosis(Iron Overload)

I need you to consult local " HEMATOLOGIST/ ENTROGASTROLOGIST" to get Hemochromatosis(Iron Overload) induced issues checked


I need you to consult NEPHROLOGIST to have your kidney issues checked may be due to LUPUS/ HEMOCHROMATOSIS. (either of the cause you need to consult nephrologist)

Please feel free to contact me in case of further clarifications or concern.

Thanks again.

Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 1 hour later

You mentioned that the neurontin (Gabapentin) that I take is contributing to my constant fatigue. I had my left leg amputated on active duty the U.S. Navy several years ago. Due to the massive trauma from my tibia, fibula, and foot being pulverized into a fine powder, and degloving my foot/leg B/K I have constant and severe phantom limb pains.

The Neurontin seems to be a much safer drug than prescription opiates. I do get prescribed opiates, but I rarely ever take them, except when I have a really bad day.

I also receive selective nerve blocks in my lower spine, and these blocks relieve a great deal of the pain Ithat have

Do you know of a better alternative to neurontin?
Answered by Dr. Jay Patel 59 minutes later
Hello sir,

I can't thanks enough for your duty to our nation sir.

Now Neurontin is a drug that acts on GABA receptors which basically stop pain sensation reaching to brain. Now in the same fashion it will stop excitement to reach brain which in turn felt as tiredness.

Now when ever any drug that acts on brain/ nerves it will likely to create same kind of side effects, and the drug Neurontin is best in class and other alternative will have same side effects and some of them have even more side effect profile, I would recommend you to stay on the same drug if possible. Making to many changes with drugs working on nerves/brain is not advised.

Now about the opiates you are doing excellent by not taking unless the pain is way far beyond the tolerance. I thing the I can say the tag line of army - you make then strong and we make then Army strong. (I know your were in navy, please don't get offended for me its just the patriot fighting for nation's freedom )

Thanks again , and feel free to contact me, now you know where to find me incase you need me.
Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 54 minutes later
Thank you very much Sir. I appreciate you taking the time to explain everything to me. I'll make the appts with the specialists you told me to consult. Ill keep you informed on any new results I get.
The Army line didn't offend me. My Dad was an Army Ranger for 30yrs. He fought in in WWII, Korea, and 3 Tours in Nam. I am in a non profit Veterans club that raises money for homeless Vets, Disabled Vets, care package drives for Active Duty Troops Overseas, and big toy & food drives during hollidays for any local families who need the support. It's always nice to talk to someone who supports the military. I wish the (VA)Veteran Affairs Hospital had more Doctors like you. Sir, it has been a pleasure chatting with you. I'll talk soon.

Very Respectfully,
Answered by Dr. Jay Patel 1 hour later
Hi Sir,

Thank you so much, I am glad I could be helpful. Its wonderful to know a true patriot.

Thanks again for having faith in me, and feel free to contact me in case of any future queries.

Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 3 hours later
I talked to a friend of mine who was diagnosed with hemochromatosis 2 yrs ago. He had very high liver enzymes and his kidneys showed a very low GFR.
He had to see a specialist who told him he had to donate 1 pint of blood each month in order to lower the iron levels in his organs. After 6 mos of giving blood, The doctor gave him a full panel blood test, and all of his levels went back to normal.
I don't know if any of this info might be important. For over the past year I always seem to be constipated. I eat plenty of fiber and also take fiber supplements, but I always have constipation. I only have one bowel movement a day, but my bowel movements are very hard to pass.

5wks ago I went to the blood bank and donated a pint of blood. This past Monday I donated another pint of blood. This seems kind of odd, but I haven't been constipated over the past 3 days. I'm even sleeping better since I gave this second pint of blood.I spoke to my friend a few minutes ago, and he told me he had severe constipation before he started having his blood drained. He told me the Doc said high iron will constipate you. I XXXXXXX wake up with headaches and feel hung over, but I haven't felt like that since I gave blood this second time. Do you think my symtoms look more like hemochromatosis/Iron Overload?
Answered by Dr. Jay Patel 15 hours later

Lets start understanding the HEMOCHROMATOSIS together and then I will answer your question to the point which will be easy for you to understand and I will reason through the logical understanding.

Hemos + chromatosis - hemo= blood and chrome= color - which means color of blood.

Now its a genetic issue, (for simple understanding )some genes (dna) attracts iron more then other (dna) structure its like magnet attracting iron and not to other metals.

So you have genes what attract more iron hence it will be absorbed more from diet you eat, more over we being male do not loose blood in monthly periods as women do, so loosing blood in case of female helps to balance the extra iron absorbed from diet, on the other hand male do not have that so we tend to gain iron in every diet, best way to loose iron from body it to flow blood out.

Now what does the extra iron in body do? answer is extra iron in body will get deposited in various organs like liver, kidney and disrupt their normal function. (for e.g- The rust will clog up the pipe of water, in the similar fashion excess on iron will act as barrier to normal cells function leading to various issue in different organ systems )

Now coming to your questions sir.

1) It is true excess of iron will disrupt the function on liver and kidney and the disturbed function can be noted in liver by increase in liver enzyme and decrease in GFR (Glomerular filtration rate, i.e- urine filtration from blood)- in kidney.

2) Ok now as I tried to explain about HEMOCHROMATOSIS in above passages, hope you are following it, (if not you may contact me to have clarification) So based from that its certain that the excess on iron in body will cause disruption, now excess of iron in gut will cause constipation which you were facing and now got it normal.

So donating a pint of blood every 1-2 month is the best way to get the excess of iron for the body. And I appreciate you donation the blood, as its noble cause and you are the person it will be beneficiary to get rid of extra iron so its like double deal for you.

So instead of thinking HEMOCHROMATOSIS as burden/ disease , I insist you to think as a one more chance given to you by god to help humanity. Please keep donating the blood ever 1-2 months and have your blood iron panel checked ever 3 months.

You will feel fresh and different as more and more iron exit your body and it will change you issues feeling fatigue bit on positive side (meant decrease the feeling of fatigue).

Donating blood is as MAGICAL SILVER BULLET in your arsenal and I hope you will continue doing it.

Thanks again for sharing all the information, and feel free to contact as usual.

Above answer was peer-reviewed by
Follow-up: Positive on nuclear antibody test and SS-B bioplex. Suggested to check for hemochromatosis. Suggestions? 3 hours later

It is my pleasure to donate blood. I have always donated when I was on active duty in the Navy. I have AB+ blood type, and I know its one of the more rare blood types that someone is in need of out there.

Doc, do you think my GFR will get any better, once I get my iron levels back to normal?

I eat really well, drink plenty of water, and I try to keep myself in pretty good physical and mental condition. I lift weights 5-6 days a week, and I am finally back to running on my new prosthetic several miles per week. I was running 3 miles in 18min last year, but I started getting chronic infections in my stump from an improper fitting prosthetic socket. I'm just glad to be able to run again.

I try to visit Veterans who are returning home or even Civilians from vehicle accidents with missing limbs, and show them that they can live a pretty normal life. I think God kept me around for a reason. I didn't have anyone around to tell me everything was going to be ok, so I try to give a little help and advice to anyone who might need it.
Answered by Dr. Jay Patel 2 hours later

Welcome back, it a honor to know a person like you who is so full of life, it a great work, more over you are AB+ the rarest of blood group. Well I have seen patients dying due to lack of AB+ blood, so I can't thank you enough, you may not know whom you helped but God certainly will favor you back as you did his work.

The best work you are doing to give a PSYCHOLOGICAL support to soldiers is a great thing, I can't help any soldier by giving psychological support as I had never been through what you went through.

Let me answer you question about GFR getting better.

Here are few facts, most of the people got it better and they were prescribed steroid for the lupus induced kidney problems, but if you have hemochromatosis induced kidney issues I can't answer of sure as the results varies across the board I have seen only 8-10 patients with hemochromatosis and all have varied results, so I insist you to ask that same question to your nephrologist as he will be best person to ask as he would have more experience in cases like yours.

Still we can discuss his opinion and in case you need to decide some thing, you know where to find me sir.

Thanks again
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