Posts by restlesscobra13

Maria Fisher46 said:ANA is negative in your case. With these results, it seems unlikely that you have active systemic rheumatoid disease right now. I might look over your file again once I have more free time and will reach out if anything else comes to mind. I noticed you mentioned swollen joints earlier, so I was wondering if those were ever formally assessed—have you had an ultrasound or X-ray on the swollen areas, and if so, what did they show?

Hello, thank you for looking into this. My main issue right now is significant pain around my lymph nodes, specifically in my neck (including some above the collarbone) and my armpits. An ultrasound showed they are reactive, though I'm still unsure about the cause.
The swelling is located on my right pinky, between the metacarpus and proximal phalanx, and on my left hand between the carpus and metacarpus. I also have slight soft tissue swelling on my right forearm near the abductor pollicis longus and extensor pollicis brevis. My doctor described the joint swelling as "minimal," so I haven't been sent for further testing regarding the joints yet.

Maria Fisher46 said:Hello,

When running serology to rule out infectious causes for swollen lymph nodes, doctors usually test for EBV and Bartonella (cat scratch fever), along with CMV and toxoplasmosis; HIV is also often considered. Other pathogens aren't typically tested routinely unless your medical history suggests they might be relevant.

There are other rheumatological tests to consider, but I guess it would be best to wait for the current results before deciding on those.

Hello,

Thank you so much for your response and for taking the time to help.
I had blood work done on February 23, 2021. I'm attaching links to the results here. (CBC, sedimentation, biochemistry, CRP, immunoglobulins, anti-CCP, RF, thyroid hormones, ANA, covid)
https://ibb.co/jJYS7b5
https://ibb.co/L534Xdk
https://ibb.co/XLW0098
The abnormal values are:
MPV 13.1 ( ASO 675 ( anti-TPO 65.32 ( I also had a peripheral blood smear performed.
Neutrophils 67 (44-72)
Lymphocytes 22 (20-46)
Monocytes 10 (2-12)
Eosinophils 1 (0-7)
Red blood cells, granulocytes, and platelets look normal morphologically. There are no immature hematopoietic cells.
Does an ANA titer count as positive or negative if the threshold is Maybe you have an idea of what the next steps should be?

Kimberly Ward said:Bates Clinic, Villa Clinic, Butterfly Clinic, Saint Roch Clinic, Saint Catherine Hospital in New York City, and Phoenix Clinic.

Thanks so much

Hey everyone, I could probably use a recommendation for a private endocrinologist in New York City, maybe someone other than the Lacic Clinic. It’s regarding a thyroid issue.

restlessbadger2 said:Does anyone know how to see a geneticist as an adult? My doctor claims there isn't really a geneticist "for adults" since they all work under pediatrics, so she can't just refer me to them. Has anyone dealt with this before? 🙂

My search results are only showing the Institute of Genetics and Metabolic Diseases at Johns Hopkins Hospital within the pediatric department. 🤷

Also, I could use a recommendation for a good private immunologist or rheumatologist. I'm thinking about seeing Dr. Bosnic, but I've been reading some pretty bad reviews from the last few years...

Dr. Bosnic works at the Josip Konj Clinic. She was okay for me, though she seemed a bit rushed since I was her last patient, but maybe she's more relaxed if you aren't the last one on the schedule.

Hello,

I have been struggling with aching joints, bones, and muscles for about two months now. It started out pretty minor, but I guess it has been getting worse over time. Some of my joints are swollen, and even some of my muscles feel inflamed. On top of that, an ultrasound confirmed I have reactive lymph nodes in my neck, armpits, and groin area. My abdominal ultrasound came back normal, though.
I had Strep A in my throat maybe four or five times, if not more, and now I’ve also tested positive for Group B Strep.

Back in December, my CBC and peripheral smear were both within the normal range.
Earlier this month, I had a CBC, ESR, CRP, and ASO titer done. My monocytes were slightly high (12.2, with 12 being the limit), my MPV was elevated at 12.5 (normal is under 10.4), and my ASO was quite high at 695 (normal is under 200).

An immunologist has ordered testing for RF, CCP, and HLA-A, B, and DR loci. My radiologist even suggested a lymph node biopsy to figure out what's going on and recommended I get some serology done, but I am not sure which specific tests to ask for.

I am thinking about getting a CBC, peripheral smear, liver enzymes, ALP, LDH, CRP, and ASO checked again, and perhaps testing for EBV and Cat Scratch Disease.
If anyone has other suggestions for tests I should consider, I would be grateful.

Thank you.

1. Full lab results and reference ranges - the first number is from 4/11/2020, the second is from 12/14/2020. I will list them as - first result / second result, and I'll mark numbers above or below the reference range in **bold**, and those near the limits (high or low) with underlining.

RBC 4.72 / 4.67 (10e12/L 3.86 - 5.08)
Hemoglobin 139 /136 (g/L F 119 - 157)
Hematocrit 0.405 / 0.410 (0.350 - 0.470)
MCV 85.8 / 87.8 (fL 83.0 - 97.0)
MCH 29.4 / 29.1 (pg 27.4 - 33.9)
MCHC 343 / 332 (g/L 320 - 345)
RDW 12.9 / 12.2 (% 9.0 - 15.0)
Platelets 189 / 258 (10e9/L 158 - 424)
MPV 12.2 / 12.7 (fL 6.8 - 10.4)
WBC 6.9 / 4.9 (10e9/L 3.4 - 9.7)
Neutrophils 52.9 / 46.6 (% 44 - 72)
# 3.16 / 2.30 (10e9/L 2.06 - 6.49)
Lymphocytes 30.5 / 34.0 (% 20 - 46)
# 1.82 / 1.68 (10e9/L 1.19 - 3.35)
Monocytes 11.4 / 11.9 (% 2 - 12)
# 0.68 / 0.59 (10e9/L 0.12 - 0.84)
Eosinophils 5.0 / 6.9 (% 0 - 7)
# 0.30 / 0.34 (10e9/L 0.00 - 0.43)
Basophils 0.2 / 0.6 (% 0 - 1)
# 0.01 / 0.03 (10e9/L 0.00 - 0.06)
CRP both times 0.4 (mg/L 0-5)

other results taken on 4/11/2020.
ESR 10 (4-24)
Urate 196 (μmol/L 134-337)
Urea 3.1 (mmol/L 2.8 - 8.3)
Creatinine 52 (μmol/L 49-90)
Bilirubin 11.7 (μmol/L 3.20)
Glucose 5.0 (mmol/L 4.2 - 6.0)
Cholesterol 3.9 (mmol/L recommendation < 5.0)
HDL Cholesterol 1.4 (mmol/L F recommendation > 1.2)
LDL Cholesterol 2.0 (mmol/L recommendation < 3.0)
VLDL Cholesterol 0.5 (mmol/L 0.1 - 0.5)
Triglycerides 1.0 (mmol/L recommendation < 1.7)
Atherogenic index 2 (1 - 5)
Alkaline phosphatase 50 (U/L 54 - 119)
AST 16 (U/L 8 - 30)
ALT 11 (U/L 10 - 36)
GGT 10 (U/L F 9 - 35)
Iron 10 (μmol/L 8 - 30)
TIBC 53 (μmol/L F 49 - 75)
UIBC 43 (μmol/L 26 - 59)

other results taken on 12/14/2020.
ASO 709 (kIU/L 0 - 200)
TSH 1.61 (mU/L 0.27 - 4.20)
FT3 5.32 (pmol/L 3.95 - 6.80)
FT4 17.85 (pmol/L 12.00 - 22.00)
Anti-TPO 49.71 (kIU/L < 34)
Anti-Tg 20.20 (kIU/L < 115.0)
Peripheral blood smear
Neutrophil granulocytes 44 (44-72 %)
Lymphocytes 37 (20-46 %)
Monocytes 10 (2-12 %)
Eosinophil granulocytes 9 (0-7 %)
Basophil granulocytes 0 (0-1 %)
Blood cell morphology
RBCs: normocytosis, normochromia.
Granulocytes: normal nuclear segmentation and cytoplasmic granulation. Lymphocytes mature, morphologically normal.
Platelets: normal count in smear, normal morphology, one macroplatelet with normal granules.
Immature hematopoietic cells were not found.

2. 22 years old, 5'2" tall, 97lbs

3.Reason why I had these tests done
I have a full post on the forum listing all my symptoms View on reddit
But in short, it all started about two months ago and the symptoms began to develop as follows:
- tingling in my left arm, pain (muscle and nerve) in the left arm spreading to my neck, shoulders, back, and right arm
- slight sore throat
- ringing in ears that comes and goes
- pain and a burning sensation in my shins
- joint pain and swelling in the pinky finger joint and between the wrist and the index finger metacarpal on my left hand
- popping in my jaw (TMJ)
- small bruises on my shins that I only notice when they turn yellow (only a few centimeters wide; I know I hit myself for some, but I can't remember others)
- swollen cervical lymph nodes
- current status: swollen lymph nodes in the neck, armpit, and groin area (had an ultrasound, they are reactive lymph nodes), occasional pain in my shins, neck muscles, and arms, a few lumps (I think I hit myself for some, about a couple cm wide), and pain at the outer corner of my left mandible.

4. Medical History
- Chronic tonsillitis, plus allergic and vasomotor rhinitis.
- Cervical erythroplakia and reactive cellular changes suggesting inflammation (I am still treating this condition currently).
- Possible Hashimoto’s.

5. I have been feeling pretty low mentally lately, which caused me to lose about 2 lbs. I am holding steady now, though I might even be gaining a little weight. I was recently on antibiotics due to a high antistreptolysin titer, which I need to retest in a month. Generally, I tend to get strep infections, though they show up differently every time. I don't usually run a fever.

My main concern is how much my white blood cell counts have been fluctuating over the last month. My Neut levels dropped, while my Eos and Mono levels went up, and so on. Also, I guess I wonder why lymph nodes would pop up in so many places (my abdominal lymph nodes look normal) alongside all these symptoms.

Thanks in advance, and sorry for the long post.

Does anyone have a recommendation for a private immunologist or rheumatologist in the Washington, D.C. area?

On top of those other issues, I've been noticing some bumps appearing below my knee over the last week or two. Right now, I have about 7 or 8 of them; they're yellow and mostly round, roughly 2-3cm in size.

restlessdriver said:Maybe you were bitten by a tick? I guess you should check for Louis Pasteur since those symptoms overlap with MS—you know, the muscle issues, numbness, and neurological stuff.

It wasn't a tick or any kind of insect.

My primary care doctor gave me an antibiotic based on what my ENT suggested. I think I'll need to get my strep titers checked again early next month.

Jacob Lopez51 said:If doctors can't explain the symptoms, they usually just point you toward a psychiatrist. I guess maybe you might be a bit burnt out, so it could be your central nervous system or some chemical imbalance. It might be a good idea to get an MRI of your brain just to rule everything else out. This seems like it could be anxiety-fibromyalgia.

You should probably also check your B12 and Vitamin D levels, along with rheumatoid factor, ANA, thyroid antibody panels, insulin resistance, and cortisol.
What were the actual test results? They really should align with what shows up on the MRI...

I had blood work done on Monday and have some new results.
My thyroid hormones look fine, but my anti-TPO isn't, and they told me I'm slowly heading toward Hashimoto, though I don't need medication yet. My B12 is okay, but I was prescribed Vitamin D. My ASO titer is 709, while the normal range is up to 200.

I haven't done an MRI yet since I went to see a physical therapist first.

Nicholas Mendoza60 said:Maybe cut out gluten.
I guess he could trigger thyroid issues.
Since you're young, maybe just nature and faith will help you feel better.
Low blood pressure can be tricky.

Thanks so much for the reply.
I suppose I'll just wait and see what happens, especially since my knuckles and fingers have started aching. My strep titer is also high at 709—normal is up to 200—even though my throat swab was negative. We'll see how it goes.
I'm hoping everything works itself out.
I actually prefer having low blood pressure, since everyone else in my family deals with really high blood pressure.

Nicholas Mendoza60 said:Maybe check your blood pressure three times a day; low pressure could be an issue.
Try seeing if the weather changes affect you, like when atmospheric pressure shifts.
If an MRI doesn't show anything wrong with your spine or such,
then maybe it's just poor circulation, which might lead to seasonal depression.
It might be worth getting a serotonin blood test.
Also, check your T3, T4, and TSH levels.

Things should start looking up by early March 2021.

Thanks for the reply.
My blood pressure is generally pretty low, around 95/60.
I had my thyroid panels done and they seem okay, though the antibodies aren't great (anti-TPO is 49.71, and it should be under 34, while anti-Tg is 20.20, where it should be under 115).

Thanks for getting back to me.

My symptoms started about two months ago when my left arm began tingling. Over the last few weeks, the pain has spread to my neck, back, shoulders, and occasionally causes headaches. I also deal with tinnitus from time to time. There is some suspicion regarding Hashimoto, but I am also really prone to strep throat infections (almost every winter). I saw an ENT specialist who mentioned I have vasomotor rhinitis and chronic tonsillitis. On top of that, the lymph nodes under my chin and in my neck are swollen, though the cervical ones are only slightly enlarged.

Hello everyone,

I am reaching out today with my very first post.
Over the last week, I have been mostly dealing with joint pain—some joints are actually swollen—and an aching sensation in my shins, almost like I applied a cold gel to them.

Blood work results:

RBC 4.67 (3.86-5.08)
Hemoglobin 136 (119-157)
Hematocrit 0.410 (0.350-0.470)
MCV 87.8 (83-97)
MCH 29.1 (27.4-33.9)
MCHC 332 (320-345)
RDW 12.2 (9-15)
Platelets 258 (158-424)
MPV 12.7 (6.8-10.4)
WBC 4.9 (3.4-9.7)
Neutrophils 46.6 (44-72) # 2.30 (2.06-6.49)
Lymphocytes 34 (20-46), #1.68 (1.19-3.35)
Monocytes 11.9 (2-12), #0.59 (0.12-0.84)
Eosinophils 6.9 (0-7), #0.34 (0-0.43)
Basophils 0.6 (0-1), # 0.03 (0-0.06)

Iron 11 (8-30)
CRP 0.4 (0-5)
ASO titer 709 (0-200)

TSH 1.61 (0.27-4.20)
FT3 5.32 (3.95-6.80)
FT4 17.85 (12-22)
anti-TPO 49.71 (<34)
Anti-Tg 20.20 (<115)

Vitamin D, 25-OH,D 48.5 (recommended 50-200, insufficiency 24-74)
Vitamin B12 502 (145-637)
Folate 11.1 (recommended 7-39)

I guess I am wondering if strep could be causing my joint pain. It has lasted about a week now, and I am not quite sure what to do. My shins hurt and feel like they are radiating coldness. I also deal with chronic tonsillitis and vasomotor rhinitis according to my ENT.

Around late October or early November, I started feeling numbness in my left arm. The first time it lasted a few hours. A couple of days later, my left arm went numb again, though it was much more intense and lasted longer this time. I could still move my arm and everything felt normal physically, but there was this constant tingling or burning sensation. I called my primary care physician, and she suggested it might just be my cervical spine. She told me to try some exercises, take some Advil, and check back in a week.

I went in for blood work the next day (CBC, TSH, CRP, sedimentation, urinalysis, metabolic panel, TSH). Everything was within the normal range except for my MPV (12.2, whereas the limit is 10.4), and my monocytes were at 11.4% (normal is up to 12%). During that week, the general tingling subsided, but I began experiencing nerve and muscle pain. The pain started spreading into my back, shoulders, neck, and head (mostly the forehead and the back of the head). I called my doctor again, but she wanted me to continue the Advil and exercises for another week.

I decided to go ahead and schedule a full physical on my own (breast ultrasound, abdominal and pelvic ultrasound, lymph node ultrasound, EKG, CBC, urinalysis, PAP smear). Results showed BI-RADS 2 for the breasts, erythroplakia on the cervix measuring 1.5cm, elevated monocytes at 12.6% (limit 12%), slightly high MCHC at 349 (limit 345), and an MPV of 12.3. My PAP smear showed reactive changes in the cells related to inflammation. The doctor who performed the exam noted that everything looked fine overall.

I saw a neurologist, who suspected cervical brachial syndrome. He ordered an MRI of my cervical and thoracic spine, an SSEP of the median nerve, an EMG, and an EEG.

In early December, I had the MRI done. For the cervical spine, there were abnormalities—osteophytes, and a disc protrusion at the C5-C6 segment (1.3mm) paramedian to the right, which reduces the anterior epidural space, along with minor degenerative changes. For the thoracic spine, the findings included straightened thoracic kyphosis, and at the level of the Th8, 9, and 10 vertebrae, a length of about 6.2cm where the disc slightly widens the central spinal canal, measuring 1.2×1.5mm.

I went back to the neurologist, and he said the MRI doesn't actually explain the cause of my pain and numbness. Because I mentioned joint pain, he now suspects arthritis and recommended I see a physiatrist.

I saw the physiatrist, but she didn't find anything significant either. She said there were no signs of arthritis (my elbows were sensitive near the lateral epicondyle but the Milsov test was negative; positive Tinel sign over the left carpal tunnel, ID around 5-6cm, and flat feet). She recommended therapy consisting of five ultrasound sessions on the trapezius, local massage, and five TENS sessions for my neck and hands.

Other tests I had done in early December include an ENT evaluation (vasomotor and allergic rhinitis with chronic tonsillitis, enlarged angular lymph nodes), an orthodontist visit (who gave me a splint because my TMJ clicks), and a neck ultrasound (small reactive lymph nodes near the anterior edge of the SCM on both sides, a couple of reactive submandibular lymph nodes up to 15mm on both sides, and an inhomogeneous thyroid structure suggesting possible lymphocytic thyroiditis—maybe Hashimoto?).

Over the last few days, I've been feeling joint pain and have had ringing in my right ear a few times. Today, I'm feeling pain running from my right knee down to my foot.

I was pretty active in sports until I was 14, but I just started lifting weights about a week ago. I don't smoke or drink. I tend to get sore throats during the winter, and I've had a few strep infections (the last two didn't involve a fever, just a scratchy throat). Generally, I spend most of my time sitting or lying down. I'm 5'2" and 95 lbs, 22 years old. In my immediate family, there is a history of high blood pressure, hyperthyroidism with suspected Hashimoto, benign uterine tumors, glaucoma, and arthritis. I should also mention that my mental health has been pretty poor since all this started (I've lost weight because I have no appetite).

Does anyone have any ideas on what to do next? Thanks to everyone who takes the time to read this.