Posts by Hannah Kelly

Maria Fisher46 said:Unfortunately, that isn't an option right now.

Aside from the facial flushing and capillary breakage, how would you actually describe the rest of the skin issues? I mean, is it just redness, or are we talking blisters, acne-like bumps, or maybe rough plaques? And do they pop up on a schedule based on sun exposure? Like, does it happen minutes or hours after being out in the sun, then vanish once you're back inside?

Excessive capillary breakage might just be a sign of fragile vessel walls. It could be hereditary, too—especially in women, if there’s a family history of this kind of thing. If that's the case, there isn't really a specific treatment.

Given the skin changes you're describing, it probably wouldn't hurt to get checked out at a dermatology clinic, maybe specifically at an autoimmune specialty clinic.

You should definitely mention these changes to your immunologist. It would also be useful to verify the level of dryness in your eyes (via an ophthalmology exam, Schirmer test, BUT test, or Rose Bengal test) and your mouth.

In rare cases—though it's possible—an ANA test can come back negative even if the anti-Ro/SSA and anti-LA/SSB antibodies are positive.

I should also tell you that plenty of patients don't meet the full criteria for a systemic autoimmune disease yet, so they end up on a "waiting list."

In those situations, it's better not to rush a diagnosis. Waiting until all the criteria are met can sometimes take years.

Thank you so much, Nicholas Myers, for your patience and your time. I'm sorry I can't make it to see you, but I managed to book an appointment with Dr. Markeljevic for late November. The wait is long, but I know she's just as thorough as you are. 😉

Thanks again from the bottom of my heart. 🙂you're wonderful

Thanks, the Cat 🙂

Update: I noticed today that my capillaries are looking really burst. Also, I didn't mention that my right eyelid droops a bit—it gets pretty bad sometimes, though today it was just a tiny bit, maybe even unnoticeable.

Maria Fisher46 said:Dear Hannah Kelly,

I see the immunologist was looking at this from a few different angles.

First off—systemic lupus. However, based on the tests done so far, the evidence just doesn't support systemic lupus erythematosus (ANA was weakly positive, then negative, anti-dsDNA is negative, complement activity is normal; anticardiolipin antibodies are negative...). That’s good news.

They also considered systemic vasculitis (due to skin changes paired with general symptoms), but again, the current findings don't really point toward that diagnosis either.

Of course, the logical question that immediately comes up is whether EVERY possible test has been performed, and the answer is—no—because there are so many of them (well, not literally infinite, but you get my point).

Some of the changes you're experiencing might not be linked to an autoimmune disease at all; for instance, those halo nevi. They could potentially be tied to vitiligo.

Looking at your post, it seems you have quite a few skin manifestations along with sun sensitivity. Did that start suddenly, or has it been there since childhood?

When you go out in the sun, do the skin changes happen immediately or shortly after?

Have they taken any biopsies from those skin lesions or the sores on your leg you mentioned?

Do you experience dry eyes, burning, or a gritty feeling like sand is in them? Any dryness in your mouth or frequent dental issues?

First, let me address what I said about the CBC. I actually asked a lady who works in a lab the same thing, and she told me a CBC and a peripheral blood smear are the same thing. 🙂My apologies if I passed along incorrect info. 🙂

Nicholas, thank you so much for the effort. Honestly, I feel like I've given you more information than the immunologist! Is there any way I can actually schedule an appointment with you?

The skin issues started two years ago, and I think the sun-induced headaches have been around since puberty.
The halo nevi appeared about ten years ago (when I was 20), and I seem to find at least one new one every year.

No biopsy was taken from the leg.

My eyes definitely feel dry and gritty. My mouth has always felt dry, too. My gums bled for a long time without any obvious signs of inflammation; I used a specific rinse on them and the bleeding finally stopped.

Ashley Morris84 said:Sorry if I'm asking this out of nowhere, but I couldn't find a better thread for it.
Is a peripheral blood smear the same thing as a CBC?

I can answer that for you: they're the same thing. 🙂

Thanks a lot for the reply, Nicholas Myers 🙂

My ENA panels were canceled because my ANA came back weakly positive.
I had C3 1,000 and C4 0,190 done, but I didn't do the CH50 (I have no clue what that even is).
I had: Proteinase 3 antibodies (pr-3): Anticardiolipin IgG: 3.3, IgM: ANCA: negative
Gamma protein electrophoresis was at 17.3 back then—I guess I don't know if this tiny jump past the reference range actually matters.

As for symptoms: I had lesions on my elbows; they suspected psoriasis, but the biopsy didn't confirm it. Right now, nothing on my elbows, but then they suddenly flare up (on my toe, it won't go away even with Diprosalic). Then there's joint issues in the middle of winter when my fingers get cold (Raynaud's), sun sensitivity: maybe my eyes, headaches the second I step into the sun, especially without glasses, tachycardia, fatigue in my arms and legs, frequent bowel movements, nausea, urge to vomit, splenomegaly (2cm), and I think all my lymph nodes are slightly swollen or just palpable because I'm thin.
Body changes: capillaries are bursting on my face and chest, sores on my toe, halo moles around existing moles and in areas where I don't have any, and a red crusty growth (about 6mm) that just fell off (I thought it was a mole). Also back pain, burning in the left side of my abdomen under the ribs, and lower abdominal pain. I guess that's more or less everything, though I'm not even sure since there is so much going on. I've been doing tests for over a year now, waiting forever, and it's just test after test...

I also had an echocardiogram: everything looks fine, just some trace mitral regurgitation. What kind of tests could I do before my appointment with the immunologist, just so I can deal with them as quickly as possible?

Thanks again for the patience

Thanks everyone, looking forward to hearing back 🙂

Update: the rheumatoid factor is actually LOWER than 10 (div>

I just got more results back:

Serum Protein Electrophoresis

Albumin 57.6 % (55.8-66.1). 40.9 g/L (40.2-47.6)
Alpha 1. 4.6. % (2.9-4.9). 3.3 g/L (2.1-3.5)

Alpha 2. 8.8 % (7.1-11.8). 6.2 g/L (5.1-8.5)

Beta. 9.7 %. (8.4-13.1). 6.9 g/L (6.0-9.4)
Gamma. 19.3%. (11.1-18.8). 13.7 g/L (8.0-13.5)

Total protein 71 g/L. A/G 1.36

Rheumatoid factor >10 (up to 14)

ANA: negative
(6 months ago was 1:160)

Immunoglobulin G 12.8 (7-16)
A 0.84 (0.7-4)
M 1.18 (0.4-2.3)

Circulating immune complexes IgG 202 (up to 130)
IgM 132 (up to 100)
(6 months ago circulating immune IgG 134, IgM 86)

Serum immunofixation: no monoclonal immunoglobulin detected

Thyroid is normal (TPO 5.5, TGA IgE tTg-IgA
Please, if anyone can provide any kind of interpretation for these results. Thanks.

Maria Fisher46 said:Hello,

The whole point of this testing is based on the fact that certain HLA antigens show up more often in people with specific diseases than in healthy groups.

So, having certain antigens is linked to a slightly higher risk of developing a disease. This definitely doesn't mean someone with that HLA antigen will actually get sick! And just as importantly, someone can still get sick even if they don't have the antigen.

Regarding your specific results, I see you have HLA-DR4, which can be linked to rheumatoid arthritis.

But things aren't nearly as simple as they look at first glance. There are actually over 30 subtypes within HLA-DR4 (labeled as HLA-DRB1*0401-*0433), and only some of them are tied to rheumatoid arthritis—mainly DRB1*0401 and DRB1*0404.

It's thought that people with those specific subtypes have about a 4 times higher risk compared to the rest of the population (those without the antigen) of developing rheumatoid arthritis. For instance, about 60% of rheumatoid arthritis patients (in the US) carry one of those mentioned HLA-DR4 subtypes, and if you account for all the subtypes, that number could climb as high as 80%.

However, you can't see those fine details in your report because the typing wasn't done that deeply.

The symptoms you're describing are non-specific, so further investigation is needed to clear things up.

Having a specific HLA antigen isn't a requirement for a diagnosis, so based solely on this result, we can't say whether you have a condition or, if you do, which autoimmune (rheumatic) disease it might be.

Best regards. 🙂

Thanks a lot for the answer

🙂

Hannah Kelly said:Hi, I'm 30 years old and dealing with Raynaud's syndrome. For the last two years, I've been getting constant headaches, nausea, pain in my kidneys, hands, and legs, plus broken capillaries and more nausea.
I had HLA typing done, so if anyone could please help me interpret these results? I definitely won't be able to see an immunologist here in the States for at least another 6 months.

HLA A
1 - 9

HLA C
Nt - NT

HLA B
21 - 61

Bw4/bw6
Nt-nt

HLA DR
4 - 8

DR51/DR52/DR53

Nt- nt

HLA DQ
NT

HLA reactive antibody panel (PRA)

All boxes are empty (not sure if I should even list this)

Crossmatch test also shows all empty boxes

NOTE: 173.0

Thanks!

Does anyone know how to read this report?
And what does it actually mean?
Thanks

Hey everyone, I’m 30 and dealing with Raynaud's. For the last two years, I've been hit with constant headaches, nausea, kidney pain, and issues in my hands and feet—plus broken capillaries and vomiting.
I just had some HLA typing done, and if anyone could please help me make sense of these results, I'd really appreciate it. I can't get an appointment with an immunologist here for at least another 6 months.

HLA A
1 - 9

HLA C
Nt - NT

HLA B
21 - 61

Bw4/bw6
Nt-nt

HLA DR
4 - 8

DR51/DR52/DR53

Nt- nt

HLA DQ
NT

HLA reactive antibody panel (PRA)

All the boxes are empty (not sure if I should even be including this)

Crossmatch test results are also all empty

NOTE: 173.0

Thanks!

Hannah Kelly said:Can someone please explain these biopsy results from my scalp nodule?

The sample collected was extremely minimal. The smear shows some pink extracellular material, droplets of extracellular fat, and just a few thin strands of connective tissue.

Thanks

Does this mean everything is fine? I guess maybe?

Can someone please explain these cytology results from my scalp lump biopsy?

The macroscopic description shows very little material was collected. The smear reveals some pink extracellular matter, droplets of extracellular fat, and just a few thin strands of connective tissue.

Thanks

Hannah Kelly said:Could someone please help me understand my blood cytology results? If you need more details, I'm happy to provide them. 🙂
I just want to know if everything looks okay, or if there's any sign of inflammation or some other condition. I'm also curious about the pO2 and THbc levels...
Thanks.

I am not looking for a diagnosis, just an interpretation of the results. 🙂

Or maybe let me know who else I should talk to for a follow-up.
Thanks.

Can someone please tell me something about my blood work results? If you need more info, I’m happy to provide it. 🙂
I just want to know if everything looks okay, or if there's some kind of inflammation or other issue going on. Also, I'm curious about the pO2 and THbc levels...
Thanks.

I'm not looking for a diagnosis, just an interpretation of the numbers. 🙂

Steven Hall4 🙂I mean, I know my husband had those elevated levels because he had a few drinks just a day or two before his blood work was done.

Female, 30 years old. Shortness of breath, tachycardia, broken capillaries, a lump behind the ear, chronic headaches, nausea.

Blood smear results:
Blasts, promyelocytes, myelocytes, metamyelocytes, erythroblasts, plasma cells: 0
Non-seg. granulocytes: 0
Seg. neutrophilic granulocytes: (bolded) 59 ref (0.54-0.62)
Eosinophilic granulocytes: 1 (0.01-0.05)
Basophils: 0
Lymphocytes: 35 (0.25-0.33)
Monocytes: 5 (0.00-0.01)

I think this is an acid-base status, but I’m not entirely sure since the test name isn't listed anywhere:

#pH: 7.47
pCO2: 4.8kPa
!pO2: 8.7kPa
Na+: 141 mmol
Ca++: 1.16
Glu: 4.4
Lac: 1.6
Hct: 37

Ca++(7.4): 1.18 mmol
HCO3-: 25.0
HCO3std: 25.8
TCO2: 26.1
BE efc: 1.0
BE(B): 1.2
#SO2c: 93%
#THbc: 115 g/l
(! Outside critical limit, #outside ref range)

Can someone please explain what these results actually mean?🙂

KCC is normal.
Ketones found in urine (2+) and specific gravity 1.010 (everything else was fine).
EKG - normal.
Chest X-ray - normal.

Skin biopsy (healthy skin): individual granular IgM deposits along the epidermal border.
Psoriasis wasn't confirmed by elbow biopsy due to more pronounced spongiosis.

Thanks.🙂🙂