Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
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:
Answers to the questions
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
1/ Are there anymore non biologic drugs I could take that will negate the immune inflammation but not affect my already low IgG levels.
Unfortunately all the drugs which negate the immune inflamation will also effect your immunity. You have some how tried all the option except one popular option i.e.: Azathioprine. Other wise you can continue good healthy practices like regular exercise, eating fresh fruits, stress-less life etc. All these have good impact on your immunity.
2/ Isnt it possible that these immune suppressing drugs may actually have caused my Immune deficiency?
Ans: Your opinion isvery likely possible. The drugs might have lowered your immunity.
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?
Ans: It generally takes 7-10 days for this to occur. The drug will leave the system and it will show a rise in your immunity. But to rgain the full immunity, it may take some more time. but flush method is not available.
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
Ans: You are already on prednisolone and taking injectable methylprednisolone may not be any more effective than this.
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
Ans: We dont jump to the higher doses right away. Let us go slow. The dose seems to be alright and the doses are generally increased gradually. I am sure you doctor will plan to increase the doses.
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?
ans: You are producing a lot of uric acid and that could be causing the symptoms of arthritis. Further measels vaccine could be responsible for the immune reaction to start. There are similar case reports available in literature. Its very unfortunate that you have landed up with this problem.
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
The findings suggest that your bone marrow is at fault. In some cases a renal problem could also lead to similar findings. Now that the problme has exsited since long, I would suggest that you should go for a renal and bone marrow biopsy.
8/ Would a blood swap assist - or would it be in my lymph nodes?
The treatment you are on will not help you with the blood swap test. Not at this stage.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Answers to the questions
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
1/ Are there anymore non biologic drugs I could take that will negate the immune inflammation but not affect my already low IgG levels.
Unfortunately all the drugs which negate the immune inflamation will also effect your immunity. You have some how tried all the option except one popular option i.e.: Azathioprine. Other wise you can continue good healthy practices like regular exercise, eating fresh fruits, stress-less life etc. All these have good impact on your immunity.
2/ Isnt it possible that these immune suppressing drugs may actually have caused my Immune deficiency?
Ans: Your opinion isvery likely possible. The drugs might have lowered your immunity.
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?
Ans: It generally takes 7-10 days for this to occur. The drug will leave the system and it will show a rise in your immunity. But to rgain the full immunity, it may take some more time. but flush method is not available.
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
Ans: You are already on prednisolone and taking injectable methylprednisolone may not be any more effective than this.
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
Ans: We dont jump to the higher doses right away. Let us go slow. The dose seems to be alright and the doses are generally increased gradually. I am sure you doctor will plan to increase the doses.
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?
ans: You are producing a lot of uric acid and that could be causing the symptoms of arthritis. Further measels vaccine could be responsible for the immune reaction to start. There are similar case reports available in literature. Its very unfortunate that you have landed up with this problem.
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
The findings suggest that your bone marrow is at fault. In some cases a renal problem could also lead to similar findings. Now that the problme has exsited since long, I would suggest that you should go for a renal and bone marrow biopsy.
8/ Would a blood swap assist - or would it be in my lymph nodes?
The treatment you are on will not help you with the blood swap test. Not at this stage.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
