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Tested HLA B27 positive. Feeling fatigued, sensitive back and buttocks. What could be the problem?

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Recently tested HLA B27 positive, XXXXXXX positive 1:160, CRP is 5, Sed rate is 44. ENA and dsDNA negative. I have been extremely fatigued for the last year and my lower back and buttocks is extremely sensitive and hurts daily. My family doctor is not really saying much except "don't worry" and I don't see a Rheumatoid doctor for a few more weeks. Can you please give me an idea of what you might think this is? If someone massages my lower back, buttocks, or hips, it almost puts me in tears. I've been taking Concerta for the fatigue and it isn't helping much.
Posted Sun, 2 Sep 2012 in Lupus
Answered by Dr. Divya Agarwal 1 hour later

Thanks for the query.

Based on the symptoms and reports, you seem to be suffering from a condition called ankylosing spondylitis.

This is a condition where you suffer from inflammatory back pain. The hallmark of this condition is sacroiliitis which in the early stages is picked on MRI and later is even visible on an x-ray.

The XXXXXXX level does not seem to be related.

I suggest you start taking a daily dose of an NSAID like naproxen or etoricoxib after consulting a rheumatologist. If the appointment is not sooner, a general physician can prescribe the aforementioned drugs to you. You should start feeling better in a few days while on these drugs.

Hope this answers your query. Let me know if you have any further enquiries.

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Follow-up: Tested HLA B27 positive. Feeling fatigued, sensitive back and buttocks. What could be the problem? 7 hours later
Thank you for answering. I've been trying Advile, Aleve, and Ibprufen the last few weeks and it helps the pain a little, bit not much. When I talked to my doctor last she said she didn't think my HLA B27 was active, bit that my inflammatory results are probably because of food intollerances. ??? (My allergist is the one who is sending me to the Rheumotoid doctor the end of this month). I don't know what to think. From what I read, a lot of the AS symptoms sounds like what I'm going through, but I just can't believe it would be something that severe. I'm scared that when I see the specialist in a few weeks he won't diagnose me as having anything. Should I mention AS to him at all or should I not? I'm not really sure what to do.

Thank you, XXXXXXX
Answered by Dr. Divya Agarwal 5 hours later

In such confusional state, I would suggest my patient to get an MRI of the sacroiliac joints to confirm the diagnosis. That is the only way to see the presence of active disease.

Otherwise if you have clinical features of ankylosing spondylitis, a competent rheumatologist should be able to pick the clues and diagnose/rule it out. You don't need to suggest anything to him, let him give his own opinion. Let me know about your rheumatologist opinion and we can take it from there.

I hope to have solved your query. Please feel free to ask anything else if u wish to.
If you do not have any follow-ups for now, please close this discussion

All the Best!
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