Brief Answer:
More information is needed and please upload some test results

Detailed Answer:
Hello,
Thank you for asking at healthcaremagic.

I carefully read your question. Scleritis most of the times is associated with other systemic conditions so having some tests and examinations to try to find the possible cause is needed as treatment should be towards the cause for it to be successful. Few times no clear cause is identified and step by step treatment is done by starting just with common anti-inflammatories and than if no improvement steroids are used. If a systemic disease is identified than treatment is directed into treating that.

Do you still have the symptoms of anterior scleritis (which are they and for how long) and have you taken any medications for it (non-steroids like ibuprofen or steroids)? Any effect with the treatment if you took it?

The work up when you have anterior scleritis is wide and much more tests are needed other than the ones you have mentioned. Have you had other tests also? Would you please upload them so i can have a look at them? Uploading your CBC would be helpful also (to evaluate your low abs lympocyte count, and other indexes there).

Have you had other examinations other than blood tests, like xrays or urine test?

Please let me know of the above information and try to upload as many lab and test reports as you can, if you had them done recently, so I can know better which is the best further step for you.

Waiting to hear back from you soon.

Kind regards,

Antoneta Zotaj, MD

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Brief Answer:
Further explanation given

Detailed Answer:
Hello again,

Thank you for the reply. I am sorry you can't upload images, you have given me some more explanations and this is helpful.

It is good your symptoms due to scleritis have subsided and you are not having a episode now.

Generally when a test for systemic autoimmune diseases comes out positive, it is good to repeat them in a few weeks to confirm that they were positive really. On the other hand I would like to emphasize that some immune tests (the ones that you have mentioned, ANA, lupus tests, rheumatoid factor, etc) can be high in healthy people also and the chance of finding them high increases with age. So the test results that were increased in your case are not specific for a certain autoimmune disease (can be high in a number or them) and also can be high in healthy individuals with age. ERS also increases with age so the value you give is very likely normal for your age.

Systemic autoimmune diseases generally start at an earlier age also, so they are less likely to start at your age. It would be very uncommon for you to start now to have a start of any of them- generally they are more common at 30-50 years of age.

To decide on a systemic disease with immune etiology other findings other than the blood serum tests should be supporting the diagnosis (they are not serologic diagnosis, specific criteria are needed to be fulfilled so the diagnosis is settled- serology is one of several criteria).

So to conclude, i would say:
1. the fact that scleritis has subsided it is a good news and as long as you have no symptoms there is nothing to worry. The fact that local drops helped with it is another reassuring factor that no systemic condition was the source of the scleritis, otherwise systemic treatment (oral or intravenous injections) directed to the systemic disease would be needed to help.
2. systemic immune diseases might cause scleritis but it is very uncommon for them to start at your age so the risk of you developing one of them now is very low
3. when serologic tests come out positive, it is always good to confirm them by repeating them in a few weeks- human mistake should be considered and ruled out.
4. many serologic immune tests (even those that you have mentioned) may be positive in healthy adults and chance is higher with age so presence of positive test results does not mean you have the disease unless you have other clinical symptoms that will classify you there
5. when you go to the doctor you might need to ask him on how much he thinks the scleritis you had is related to these test results or a certain systemic disease. You can ask him if you need other tests to confirm this (like urine tests, xrays and other blood tests)
6. if autoimmune disease is suspected (very unlikely in your case) than tests like chest xray, xray of joints if there are joints hurting or swollen, urinalysis, metabolic panel (creatinin, ALT, AST, lipids, sugar, tests), HBsAg for hepatitis B is done, and some other immune tests depending on which autoimmune disease the doctor examining you finds more likely.

I hope this is helpful and answers to your question but please feel free to reply in case more clarificaiton is needed on this.

Kind regards,

Antoneta Zotaj, MD

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Brief Answer:
You are welcome

Detailed Answer:


It is a pleasure to be able to help you.

Kind regards,

Antoneta Zotaj, MD

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