What do these lab reports indicate?

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Posted on Sat, 26 Aug 2017 in Lupus
Question: It seems like I have got RA.
I have attached 2 reports.
Could you please analyse the report and advise me like am at what stage of the disease and how much it is progressing, etc.,
Also, now I don't have morning stiffness.
Will I be getting those symptoms soon or I will never get if i take proper medications?
Thanks in Advance.
doctor
Answered by Dr. Naval Mendiratta 1 hour later
Brief Answer:
Is it arthritis

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your reports...But I would like to know a few more details about your symptoms before guiding you further. CAuse eventually, we have to treat you and not the labs...

1. DO you get any oral ulcers??

2. Any history of rashes or new rashes when you go out in the sun?

3. Any history of dry eyes or dry mouth?

4. When you say joint pains..Which joints are affected..and is there any swelling in the joints..??

5 Any history of increased hair fall???

CAuse something doesnt seem right from your reports. It doesnt look like Rheumatoid ARthritis, but a close mimic of the disease as your ANA is strong positive..

Do let me know these queries.. I will guide you further from here

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Naval Mendiratta 1 hour later
Thanks doctor... Please find my reply as desired..
1. I haven't got oral ulcers
2. No history of rashes or new rashes while out in sun
3. NO dry eyes and dry mouth. I feel thirsty at times
4. Pain and swelling observed in my right hand index and middle finger. Pain noticed in my right hand wrist.
5. Hair fall is there as usual.
doctor
Answered by Dr. Naval Mendiratta 19 hours later
Brief Answer:
Further course

Detailed Answer:
good evening

Sorry for the late reply.. had a busy day

Well, I would like to advise you a couple of tests further as your ANA is very strong positive and we should evaluate it further to see if it is connective tissue disease (which can mimic rheumatoid arthritis)

1. ENA profile
2. complement c3 c4
3. anti ccp antibody
4. urine routine
5. complement c3 c4

Do get these test done as it will complete our work up for arthritis and we can plan things further.. on how much treatment you need and how aggressive one needs to go with treatment

Regards.
dr naval
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Naval Mendiratta 1 hour later
Hello Doctor,
Good Evening.
Thanks for your response.
My Index finger became bend and am able to make it straight by keeping it in hot water. Is this any strong symptom to identify between RA and Connective tissue disease.
Btw, I have checked about the test in the Lab, they have few doubts.
1) Drlalpathlabs_MyBloodTestReport_24_July_2017.PDF - this has the result for anti ccp, Serum @ (CMIA) - Is this test is same as anti ccp antibody?
2) ENA profile - EXTRACTABLE NUCLEAR ANTIGENS (ENA), QUALITATIVE PROFILE or QUANTITATIVE PROFILE?
Thanks in Advance!
doctor
Answered by Dr. Naval Mendiratta 11 hours later
Brief Answer:
eNA profile

Detailed Answer:
good morning

well it s always a tough thing to distinguish RA and Connective tissue disease as arthritis can be a common symotom of both. So one way isnthe other symptoms which I had asked you which were negative.. and next is the blood test.. that is ANA and ENA...

Oh sorry, yes you can strike out the anti ccp antibody. it has already been done and is negative..

As for ENA, qualitative is good enough.. But I would suggest do it from SRL lab as they do more antibodies than LAL does...

Do let me know these further test

Regards.
dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 35 hours later
Hello Doctor..
Thanks for your response.
Please find the attached report for C3 & ANA PROFILE.
Please advise.
Thanks in Advance!
doctor
Answered by Dr. Naval Mendiratta 14 hours later
Brief Answer:
Connective tissue disease

Detailed Answer:
good morning

I have gone through your reports...

Well as I suspected it is not rheumatoid arthritis.It looks to be heading towards connective tissue disease probably SLE.. with the antibodies being positive and low complement...

It would be better if you seek a rheumatologist opinion in person and get started on treatment as soon as possible. Meanwhile you can begin on tab Hcqs 200 mg once twice daily

Rheumatoid factor can be positive in this disease as well.. But more or less treatment remains the same.. But yes with SLE we need a little bit more evaluation...

Do let me know for more queries

Regards
dr naval

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Naval Mendiratta 33 hours later
Hello doctor,
Thanks for your reply..
I have consulted a rheumatologist and he asked me to take anti ds DNA test... I have given blood sample and waiting for the result.
Please help me with the below queries..
1.Morning walking- is sunlight essential?
2.Food menu- should tamarind and spicy food avoided.. Any veg and fruit to be avoided? .. Best veg and fruit for this disease?
3. Is stress a major factor?
4. Is working environment like ac rooms a cause? Would you recommend continue working or stay at home
5. The disease is in what stage? Is it curable?
6. Ayurveda treatment can help my condition?
7. Will medication for 6 months will reduce RH factor and Ana value? Or will it not allow the problems to elevate further?
8. Can we keep the fingers in Salt water when we have swelling. Is it right or will it affect the internal tissues
9. Will cod liver oil eating will boost the body's health
10. Taking vacation and relaxing will cure d disease... Stress and vit d can v improve to cure it?
Thanks in advance! P
Thanks,
XXXX
doctor
Answered by Dr. Naval Mendiratta 21 hours later
Brief Answer:
Further course

Detailed Answer:
Good afternoon

Well as per your queries:

1. Well, firstly we need to determine if it is SLE or not. If it is SLE, You have to avoid sunlight as UV light can trigger the disease. Use sun screen SPF 50 or umbrella..But after confirming the disease...

2. We dont ask for food restrictions. Be careful on hygienic food from outside , thats all. If you feel something triggers your pain avoid that.

3. Yes stress is a major factor for triggering the disease...A lot of horomones vary with it and it always worsens these CTD>

4. Continue working. STaying at home is only gonna drive you crazy as you will keep thinking about the problem. Stay busy but do get your adequate rest as well

5. Stage I cant really say till I have assessed you fully. It s not curable, only controllable. Some people get controlled with 1 medicine, some with 5..SO it all depends on how your disease behaves..Sorry but without examining you I cant really comment on its stage

6. I wont recommend ayurveda.You can try it but dont stop allopathic as with these CTD, we dont depend on ayurveda as it doesnt cure either and the therapies are not recommended medically

7. Medicines are to control the problems. We dont monitor RF and ANA again as up and down of their titre holds no significance in management.Your lab values, overall well being is one which is assessed...

8. You can keep fingers in salt water.. No issues with that

9. Cod liver oil you can try..and also go for Vitamin D supplements. Both help the immune system

10. VAcations wil help avoid stress and keep you happy. It doesnt cure, but as it avoids stress it will not worsen it...

Hope I have answered your queries

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 6 hours later
Thanks for your reply doctor.
So can we confirm whether it is SLE or not by DS DNA test? I heard that there are 30 percent chances to get it cured automatically, Is that true?
what type of blood test will help to monitor the disease?
Fingers r being swollen getting better without medicine, how it is becoming normal after sometime without taking any medicine?
If I do more work using hands esp. fingers will worsen the disease or not? I. e do I have to keep my joints and muscles active by doing more work for betterment or I need to give enough rest to those? @
Thanks in advance...
doctor
Answered by Dr. Naval Mendiratta 33 hours later
Brief Answer:
SLE

Detailed Answer:
good morning

As per your query :

1. Dsdna doesn't confirm SLE. it is more of a marker for disease severity.. Since your other antibodies are positive it is a good enough reason to confirm about the disease.. along with symptoms.

2. As mentioned earlier, SLE varies person to person. some persons do good with just a single medicine only... So yes there is a chance you may not need many meds also...

3. Joint pains and swellings can come and go. It gets better itself.. but can come back also. some reasons are unexplained.. But you should keep working.. no need to rest through...

Hope it suffices. your query

Regards
dr naval.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naval Mendiratta 30 hours later
Hello doctor,
Thanks for your response.
I have got the reports for Anti ds DNA (IgG) - 313.70 IU/ml
Attached reports as well.
Please tell me how severe the disease is for me?
How about my life span?
Is my Organ has been affected esp. Kidney?
Any life style changes can help me to control the disease?
Please advise - Do's and don'ts
Thanks in Advance!
doctor
Answered by Dr. Naval Mendiratta 2 days later
Brief Answer:
Delayed Reply

Detailed Answer:
Good evening

Sorry for the delayed reply...Was out of country for a conference

Well, you seem to be panicking a lot...I will do my best to sort it out for you...

1. The Anti DsDNA is quite high...But as of now the reports of kidney and urine are all fine.SO the significance of anti ds DNA is more for monitoring of kidney involvement if it comes up

2. DOnt worry about life span. Most SLE patients lead a normal life...SLE s disease course is suppose to be around 3 years time.. If it remains in control during that time, it may not progress later as well

3. Avoid sun exposure and stress. Rest carry on your life normally...

So just be in touch with a rheumatologist. And they will monitor and adjust your treatment accordingly..

Hope it suffices your query

Regards
Dr Naval


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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