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Dr. Andrew Rynne

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What causes arthritis, lump in throat, acid reflux and disc herniation?

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Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 569 Questions

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Posted on Mon, 4 Aug 2014 in Lupus
Question: Went to see a new internal med dr today to get some information on my general health concerns
Discussed pos Ana that I've had for two years now . The numbers ranged from 1:640 to 1:1120 and at one reading was 1:320 homogeneous pattern , histones ranged from 1.7 to 4. Have been to 2 rheumatogists and all tests they ran for autoimmune were neg. I have some joint pain in my fingers knees and ankles and wrists that comes and goes. I do exercise everyday and have been for over thirty years. Have lower disc herniations and some back pain and leg muscle pain. I take one baby aspirin a day and it helps.
I was also on cymbalta since 9/2011 but stopped it four months ago because of major hairloss .
I was taking it for anxiety and back issues. I have arthritis in my left big toe and I think the left toe next to the big toe is starting to hurt . I have had acid reflux and was on medication twice last year.
My symptoms were a lump in my throat on 5/2013 and after I did an endoscopy in 10/13 I went on it again.
I feel now that when I eat a heavy meal a I get that lump again.
The internal med dr said I'm perfectly healthy for now based on all lab work and tests I have done.and to cont doing bloodwork to check for autoimmune.
I have some dyspnea also the past seven months I did pft and seeing XXXXXXX monologist this week to go over.
What do you think? Do the numbers of the Ana correlate with the diseases.
doctor
Answered by Dr. Divya Agarwal 1 hour later
Brief Answer:
may be sle if you have features of inflammation

Detailed Answer:
Hello,

Your ANA may be related to your joint pains for sure.

Arthritis is one of the symptoms of SLE, but there are usually other features like oral ulcers, hairloss, photosensitivity. Major organs like kidney and brain may also be involved.

so if the arthritis has features of inflammation like pain worse in the morning and after inactivity.
stiffness in the mornings lasting for more than half hour also if the blood work shows a high ESR then again it suggests inflammation. However if all these are negative then it may not be related as ANA.

ANA may be positive in 10% of normal people, but in such cases it is generally low titer(less than 1:160). So if you have the symptoms I describe above, then SLE is the most likely cause.

Acid reflux and dyspnea may be related however they are not the typical symptoms of SLE.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Divya Agarwal 7 hours later
My esr was tested back in dec 2014 and is neg. I have some morning stiffness but I don't believe it lasts more than half hour. I find when I work out with weights the next day my legs are sore. My fingers are a little stiff also through out the day.
My Ana was was negative back in XXXXXXX 2011 and went up to 1:640 in July of 2012.
Is that possible to go so high from neg within a years time?
Also can you refer my question to another rheumatologist for a second opinion please.
Date correction esr was tested dec 2013 not 2014
doctor
Answered by Dr. Divya Agarwal 1 hour later
Brief Answer:
then it seems like OA

Detailed Answer:
Hi,

So it seems unlikely to be SLE.
Even though you have had fluctuating levels of ANA the symptoms do not correlate to your symptoms.
The symptoms are more suggestive of osteoarthritis which may sometimes be generalised affecting the fingers , toes , knees, with some amount of stiffness and soreness.

Regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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