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Suggest treatment for persistent joints pain and tingling in hands

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Posted on Tue, 19 Jul 2016
Question: I'm a 40 year old white male who is very active. In March I started experiencing joint pain. I eventually went to a rheumatologist and had several tests done. My ANA came back positive with an ANA Titer of 1:640. My ENA SM was at 20. The test said that 1-19 was normal so I was 1 over. My ENA RNP was >100. Normal value was 0-<20 so I'm way over. All of the many other tests came back normal. My symptoms are mainly in my hands and feet. But I do feel joint pain in my should and knees too. I do get a tingling in my hands and feet some times. Now I've noticed that it seems that my calves are swollen. The rheumatologist prescribed plaquinel but I don't want to take it if I don't have to. I don't want to take medicine for the rest of my life if it's not necessary. I've always been very healthy, so this is very frustrating. I'm looking for other opinions that might provide me other options and diagnosis. My rheumatologist said that it's not Lupus, but he didn't tell me what it is. I really need some clarity if possible.
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Answered by Dr. Dr. Shruti Rijhwani (26 minutes later)
Brief Answer:
It can be MCTD.

Detailed Answer:
Dear Sir ,

Thank you for posting your query on HCM.

Well I agree with what your rheumatologist is saying . See its not always possible to label autoimmune disease into some category . But since your ANA is positive in high titre along with RNP positivity , it can be Mixed connective tissue disease . So its better to take plaquenil as it is a conservative treatment . For people whose disease is not characterised it is the safest option .And I dont see any harm in going for it .

Take care.

Dr. Shruti


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Dr. Shruti Rijhwani (25 minutes later)
If I take plaquenil for 1,2, or 3 months and it stabilizes my immune system, is it possible that my immune system will stay stable without taking the medicine?
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Answered by Dr. Dr. Shruti Rijhwani (1 hour later)
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

Thank you for reverting back.

You have to continue it for long , taking just for few months will not solve the purpose . Has your rheumatologist recommended it for few months only .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Suggest treatment for persistent joints pain and tingling in hands

Brief Answer: It can be MCTD. Detailed Answer: Dear Sir , Thank you for posting your query on HCM. Well I agree with what your rheumatologist is saying . See its not always possible to label autoimmune disease into some category . But since your ANA is positive in high titre along with RNP positivity , it can be Mixed connective tissue disease . So its better to take plaquenil as it is a conservative treatment . For people whose disease is not characterised it is the safest option .And I dont see any harm in going for it . Take care. Dr. Shruti