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Suggest Treatment For Uncontrolled Inflammatory Disorder
Question: There was no option for Pharmacist - so I chose your specialty
My health issues are puzzling and complex but a long story short is that so far I have been diagnosed with;
- Unusually high and uncontrollable Uric Acid
- Primary Immune Deficiency IgG1 and IgG3 are low (but could be drug induced, prednisone, sulphasalazine etc)
- Shunt somewhere in the body, Low ABG's and confirmed O2 shunt studies
- Psoriatic Arthritus
- Lung changes - squamous metaplasia
- Gerd
Over the years I have taken many types of medicines and they keep randomly changing them without care to what drugs may clash with another, it is indeed a balancing act, as I must try to supprss the immune response for my Psoriatic Arthritus, while at the same time I must now lower my Immune system for my Primary Immune Deficiency.
I have been told that I have tried all the mainstream standard drugs fro my uncontrolled inflammatory disorder and have in the past tried.
Methotrexate, Sulphasalazine, Arava, Prednisone (still taking on occasion) Prednisolone, Planquinal -
I apparently can nt take Biologic drugs as they may make my Immune deficiency worse, I cough blood and excrete blood but no cause has been found.
So I have quite a few qtns...
1/ Are there anymore non biologic drugs I could take that will negate the immune inflammation but not affect my already low IgG levels.
2/ Isnt it possible that these immune suppressing drugs may actually have caused my Immune deficiency?
3/ How long would I need to be off my IVIG therapy and all immune suppressing drugs, in order to run trough levels and see if my IgG levels return normal, ie how long for drugs like prednisone etc to exit the system and is there a flush method?
4/ They would now like me to go on Methylprednisone 100mg IV - but I am unsure if my current drugs interact ok, can you confirm this - the current medicines are below;
- Prednisone 5mg (for inflammation)
- Allopurinol 600mg (for high urate)
- Naproxen 750mg (Inflammation)
- IVIG Intragram P - 30mls (immune deficiency)
- Crestor 10mg (High Tryglycerides)
- Colchecine - (for gout)
- O2 therapy for low O2
5/ Am IU being under dosed for my IVIG Intragram p - I am nearly 120kg and am a large and tall man - they are looking to increase this to 36mls
6/ This inflammation problem first started after an immunization in 2006 for Measles Mumps and Rubella - could an Adjuvant or something be stuck in my blood and causing an immune response - ie could the urate be trying to work as a last line defense as an antioxidant?
7/ What do the following represent to you -
High CRP
High Plasma Fibrinogen
High Urate
High Mature T Cells CD3
High T Helper Cells CD4
Abnormal Coag Studies and Iron studies
Positive D Dimer
High Collagen - platelet function
Serum Chemistry - Low bicarbonate
Gamma Globulins - Low
High Antithrombin 3
High Protein C
High Protein S Percentage
High Erythrocytes - Urine study
8/ Would a blood swap assist - or would it be in my lymph nodes?
My health issues are puzzling and complex but a long story short is that so far I have been diagnosed with;
- Unusually high and uncontrollable Uric Acid
- Primary Immune Deficiency IgG1 and IgG3 are low (but could be drug induced, prednisone, sulphasalazine etc)
- Shunt somewhere in the body, Low ABG's and confirmed O2 shunt studies
- Psoriatic Arthritus
- Lung changes - squamous metaplasia
- Gerd
Over the years I have taken many types of medicines and they keep randomly changing them without care to what drugs may clash with another, it is indeed a balancing act, as I must try to supprss the immune response for my Psoriatic Arthritus, while at the same time I must now lower my Immune system for my Primary Immune Deficiency.
I have been told that I have tried all the mainstream standard drugs fro my uncontrolled inflammatory disorder and have in the past tried.
Methotrexate, Sulphasalazine, Arava, Prednisone (still taking on occasion) Prednisolone, Planquinal -
I apparently can nt take Biologic drugs as they may make my Immune deficiency worse, I cough blood and excrete blood but no cause has been found.
So I have quite a few qtns...
1/ Are there anymore non biologic drugs I could take that will negate the immune inflammation but not affect my already low IgG levels.
2/ Isnt it possible that these immune suppressing drugs may actually have caused my Immune deficiency?
3/ How long would I need to be off my IVIG therapy and all immune suppressing drugs, in order to run trough levels and see if my IgG levels return normal, ie how long for drugs like prednisone etc to exit the system and is there a flush method?
4/ They would now like me to go on Methylprednisone 100mg IV - but I am unsure if my current drugs interact ok, can you confirm this - the current medicines are below;
- Prednisone 5mg (for inflammation)
- Allopurinol 600mg (for high urate)
- Naproxen 750mg (Inflammation)
- IVIG Intragram P - 30mls (immune deficiency)
- Crestor 10mg (High Tryglycerides)
- Colchecine - (for gout)
- O2 therapy for low O2
5/ Am IU being under dosed for my IVIG Intragram p - I am nearly 120kg and am a large and tall man - they are looking to increase this to 36mls
6/ This inflammation problem first started after an immunization in 2006 for Measles Mumps and Rubella - could an Adjuvant or something be stuck in my blood and causing an immune response - ie could the urate be trying to work as a last line defense as an antioxidant?
7/ What do the following represent to you -
High CRP
High Plasma Fibrinogen
High Urate
High Mature T Cells CD3
High T Helper Cells CD4
Abnormal Coag Studies and Iron studies
Positive D Dimer
High Collagen - platelet function
Serum Chemistry - Low bicarbonate
Gamma Globulins - Low
High Antithrombin 3
High Protein C
High Protein S Percentage
High Erythrocytes - Urine study
8/ Would a blood swap assist - or would it be in my lymph nodes?
Brief Answer:
get done renal and bone marrow biopsy.
Detailed Answer:
Hello dear, thanks for your question on HCM and for the detailed history.
Answer to your first question.
No, I dont think of other nonbiological drugs for you. You can try azathioprine but it will decrease you immunity.
Answer to your second question.
I think yes. These immunosuppressive drugs have altered body immunity and cause iatrogenic immunodeficiency.
Answer to your third question.
If you stop your immunosuppressive drugs today than within 1 week their effect will go. And IVIG wil rise your immunity immediately. And there is no flush method for this.
Answer to your fourth question.
In my opinion, no need for methylprednisolone as you are already taking prednisolone. Both are steroids. Instead this I will prefer azathioprine as it is having different mechanism of action.
Answer to your fifth question.
No the dose is right. Once you tolerate low dose than we can increase the dose. So they are planning to increase the dose.
Answer to your sixth question.
Measles vaccine can trigge inflammatory reaction but the incidence is very rare.not much common. And you must be overproducer for uric acid. So your uric acid is high.
Answer to your seventh quetion.
You are having some problem in either bonemarrow or kidneys or both. So I advice you to get done bone marrow biopsy and renal biopsy. You may get diagnosis by this.
Answer to your 8th quetion.
At present blood swap is not indicated as you are on IVIG. So better to plan after some time. In my opinion it is either bone marrow or kidneys. So get done biopsies.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
get done renal and bone marrow biopsy.
Detailed Answer:
Hello dear, thanks for your question on HCM and for the detailed history.
Answer to your first question.
No, I dont think of other nonbiological drugs for you. You can try azathioprine but it will decrease you immunity.
Answer to your second question.
I think yes. These immunosuppressive drugs have altered body immunity and cause iatrogenic immunodeficiency.
Answer to your third question.
If you stop your immunosuppressive drugs today than within 1 week their effect will go. And IVIG wil rise your immunity immediately. And there is no flush method for this.
Answer to your fourth question.
In my opinion, no need for methylprednisolone as you are already taking prednisolone. Both are steroids. Instead this I will prefer azathioprine as it is having different mechanism of action.
Answer to your fifth question.
No the dose is right. Once you tolerate low dose than we can increase the dose. So they are planning to increase the dose.
Answer to your sixth question.
Measles vaccine can trigge inflammatory reaction but the incidence is very rare.not much common. And you must be overproducer for uric acid. So your uric acid is high.
Answer to your seventh quetion.
You are having some problem in either bonemarrow or kidneys or both. So I advice you to get done bone marrow biopsy and renal biopsy. You may get diagnosis by this.
Answer to your 8th quetion.
At present blood swap is not indicated as you are on IVIG. So better to plan after some time. In my opinion it is either bone marrow or kidneys. So get done biopsies.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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