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Having pain in hands and elbows. Astamatic, on citalopram. Mother had polymyositis and pneumonia. Suggest?

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General & Family Physician
Practicing since : 2009
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Hello , I am a 43 year old dentist, female . My mother passed away (at 63 years old) in october 2011. She had been diagnosed with polymyositis/dermacytis in 1994 and died following spinal surgery, after which she contracted pneumonia. A dreadful illness and devastating to her and all of her family. I am experiencing a lot of pain in my hands(middle) and also my elbows particularly in the morning with respect to my elbows. I am an asthmatic ( since four years old) and have been on citalopram 20 mg following a difficult separation, upped to 40mg in february this year followed by the traumatic suicide of my partner. I am aware that some autoimmune diseases are genetic, or at least there is a predeliction towards them, a mother of a four and a five year old(with very irregular periods recently) would gratefully receive your advice. kind regards XXXXXXX
Posted Tue, 2 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the query,

I am very sorry for what you have certainly gone through. I understand it could really be difficult, especially with the bringing up of the young baby you got. However you have to be very strong, the baby, the children must be your strength and continue being very positive.

Surely most autoimmune diseases are genetic. You describe a scenario of morning stiffness with classical joints involved usually in Rheumatoid Arthritis and Mixed rheumatic fever.

Investigating these diseases shall involve laboratory testing for Rheumatoid factor, Antinuclear Antibodies and Anti ds DNa for systemic lupus erythematosus and mixed connective tissue disease. In case of history of rheumatic fever, ASLO, a chest X XXXXXXX and an ECG and cardiac ultrasound would be welcome.

Otherwise, the level of inflammation could be a good measure with Erythrocyte sedimentation rates and C reactive protein level measurements. A complete blood count could show either some anemia orienting towards a rheumatologic origin. An X XXXXXXX of the painful joints in search of demineralisation lesions of the bones could further strengthen the hypothesis of a rheumatologic condition.

I strongly advise you consult an internist/rheumatologist for better care.

Please, you must be strong, for you are the pillar, the strength and everything of the children around you. whenever you look at them, you got to smile. Be strong hoping all shall be well.

Hope this helps as I am ready to contribute to your health if need be. Do not hesitate.

Best regards,

Bain LE, MD.
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Follow-up: Having pain in hands and elbows. Astamatic, on citalopram. Mother had polymyositis and pneumonia. Suggest? 41 hours later
Thank you sincerely for your advice. I will take you up on your advice,

Many many thanks
Answered by Dr. Luchuo Engelbert Bain 1 hour later

I thank you too as I wish you the best of health. Never hesitate asking further questions if need be, I will be honored and very glad making my little contribution.

Wishing you the best of health.

Bain LE, MD.
Above answer was peer-reviewed by
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