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Suffering from fatigue, weight loss, shortness of breath and back pain. Is this autoimmune disorder?

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Practicing since : 1992
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Hi I am 27 year old 6 inches tall guy who is having following symptoms since last 1.5-2 years:

1. Fatigue
2. Weight loss
3. Palpitations with shortness of breath
4.Lesser sleep (mild insomnia)
5. Back ache when stand for more than 15 minutes
6. Morning stiffness in neck, relieves with time

I want to ask if I am suffering from any autoimmune disorder..??
Actually, I had this chronic back pain since last 3 years. Consulted a neurologist and orthopedic. After few tests, one of which was HLA B-27, doctor told me I am suffering from seronegative spondyloarthropathy and will have to pop pills for rest of my life. I left that treatment after 2-3 months.
then I started to have this fatigue and tiredness whole day and palpitation and shortness of breath with feeling of dizziness (sometimes) since last 1 year. One doctor told me it's anxiety and prescribed clonazepam (clonafit) and another doctor prescribed alprazolam tablets, both .25 tabs daily but I take them SOS, either one of them not both.
Now, please guide me what is the problem. If it is autoimmune disoprder:
1. Do i need to take medicines for rest of my life?
2. Do I need to treat joint pain and anxiety (what they call it, I am not sure) at the same time or separately
3. Or I need to visit XXXXXXX medicine department.

For symptoms like palpitation, shortness of breath, sweating of palm, high heart rate, vertigo (or dizziness) while standing suddenly after sitting and feeling flushed and passed out while using stairs, I talked to cardiologist also, my BP was a bit high (90-135, and only once it reached 100-145) but echocardiogram and holter monitoring went fine witout any issue). So all is well i guess here with my heart.

I have sinusitis also.

Please help.
Posted Sat, 3 Nov 2012 in Asthma and Allergy
 
 
Answered by Dr. Ravinder Sharma 10 hours later
Hi
I am Dr Ravinder Sharma.
On the basis of the information provided it is difficult to draw a conclusion about your illness. Symptoms are our guide to think of the different possible diagnosis a patient is suffering from
First I look at your symptoms for last 2 years

1.Fatigue
2. Weight loss
3. Palpitations with shortness of breath
4.Lesser sleep (mild insomnia)
5. Back ache when stand for more than 15 minutes
6. Morning stiffness in neck, relieves with time


with these sympttoms I would like to keep thyrotoxicosis (disease of thyroid gland where there is increase in thyroid hormones in blood causing weight loss, fatigue, palpitation, insomnia ), Paroxysmal Atrial Tachycardia ( sudden increase in heart rate which settles after some time just to reappear after some time, common in young adults. Excessive intake of coffee, tea, smoking may contribute to this), somatoform disorder (multiple symptoms - gastrointestinal symptoms, urinary symptoms, headache, backache, cardiovascular symptoms and respiratory symtoms) or anxiety neurosis (panic state, palpitation, sweating, fear of impending doom )

You have already consulted a orthopedic surgeon for joint problem and you were diagnosed with seronegative arthropathy.

Now for the second part of your question


is it a autoimmune disoprder

It would be appropriate to consult a Immunologist at SGPGIMS Lucknow. You will be required to undergo some tests to say whether it is an autoimmune disorder or not

1. Do i need to take medicines for rest of my life?
I feel you need a work up from a team of specialists comprising of
Physician
Cardiologist
Endocrinologist
Psychiatrist
Orthopedic surgeon

After a consultation with these specialists and the investigation reports it would be easier to say what medication are required and for how long. If it comes out to be autoimmune disorder it will be required for the lifetime but there are drugs to alter the course of disease. So treatment slows the disease process and decreases the chances of complications
2. Do I need to treat joint pain and anxiety at the same time or separately

You will need treatment depending on the cause. It would be appropriate to think about it after diagnosis

3. Or I need to visit XXXXXXX medicine department.

The team of doctors I have mentioned above includes physician (internal medicine)
also

I hope this answers your concern
Feel free to contact me if you need more information about it

with warm regards
Ravinder Sharma
Above answer was peer-reviewed by
 
Follow-up: Suffering from fatigue, weight loss, shortness of breath and back pain. Is this autoimmune disorder? 1 hour later
thanks sir for quick n detailed response. i want to clear few things mentioned in the first phase of your answer. i hav had thyroid related tests which were normal. secondly i hardy take 1-2 cofee in a day and i dnt smoke. i want to mention one more thing here is i was told by a physician to go for 24 hour urine test for catacholamine n few other things as these symptoms of palpitation among other may be becasuse of liver related tumour or malfunctioning, dats what he told me. should i go for this 24 hour urine test?? and medicines for seronegative spondyloarthropathy are for lifetime or for few years..?? symptoms may suggest panic attacks also but i dnt hav any reason for depression and my personal n official life is good so these palpitation, shortness of breath, fear of getting unconscious, sweating, dizziness n vertigo can be because of any other reason as well. do they suggest any serious illness..?? these kind of attacks dont get triggered by anything. these can come at anytime. sometimes even while sleeping. so please suggest
 
 
Answered by Dr. Ravinder Sharma 3 hours later
Hi
Thanks for a follow up of your query
I would suggest to
1. Undergo 24 hour urine test for catechoamines
2. Medical treatment for seronegative arthropathy is required for a long time. The peak incidence of the disease is seen in young adults. The response to drugs is variable in patients and it is difficult to predict. Once you are in the treatment the course of events and symptoms decide on further treatment -- some of the patients require treatment for lifetime and in some patients the need of treatment decreases.

Panic attack and anxiety neurosis is at subconcious level and the sufferrer is not the right person to judge about it. Somtimes there are trivial issues which we feel are not important but may present in this manner. I would suggest you to consult a neurologist and a psychiatrist about it. You may require some tests before a final diagnosis is made

I hope this answers your concerns
Feel free to contact me if you need more information

with regards
Ravinder Sharma
Above answer was peer-reviewed by
 
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