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Suffered Jerking Arms,legs, Headaches, Dark Urine. Can Someone Look Into Lab Results And Explain

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Posted on Tue, 3 Jul 2012
Question: thank you for your help with labs, i have had some more come back and would to know how seriouse they are,,
health history, 44 light smoker male 165lbs, (unstable BP 150/100-- to 88/49 pulse 79) occ, daily range
unknown diag for jerking arms legs body when lying or sitting 3 mnths, unexplained loss 30 lbs 90 days, (malar rash, butterfly face,) some sensitivity to light florescent and sun, cola colored urine occ, head aches, extremely painfull knees when getting up in am no injury? back djd ,hip os, getting more paniful and loss of flexation ability. elevated ESR 12, AFP 14, MCHV ,please see other labs sent during last question.
please help my pain and symptoms worse and my VA Doc dont seem concerned,
meds, butrans patch 20 pain, tramadolo pain, statin med for bp, muscle relaxor for jerking body no help. trazadone & celexia for PTSD, anti biotic for malar rash no help,
     
LAB Comments:      
No lupus anticoagulant was detected. Results are consistent
with the presence of one or more factor-specific inhibitors.
Since the dRVVT was within normal limits, the factors in
question are VIII, IX, XI, XII and the contact factors.
----------------------------------------------------------------------------------------------------
COAGULATION DILUTE XXXXXXX VIPER VENOM INDUCED      
45.0      sec      0.0-50.1      

COAGULATION DILUTE XXXXXXX VIPER VENOM INDUCED ACTUAL/NORMAL      
65.8 High      sec      0.0-50.0      Details

LUPUS ANTICOAGULANT NEUTRALIZATION.HEXAGONAL PHASE PHOSPHOLIPID      
5.8      sec      0.0-8.0      Details

LUPUS ANTICOAGULANT NEUTRALIZATION.PLATELET      
60.3 High      sec      0.0-50.0      Details


doctor
Answered by Dr. Jasvinder Singh (9 hours later)
Hello,
Thanks for posting your query.

I can understand your concern for these symptoms and your laboratory findings. Given your symptoms, there is a high possibility that you are having SLE (joint pains, multiple body aches, myalgia, malar rash, low grade fever, headaches, hematuria causing cola colored urine or proteinuria.

The tests that you have undergone are the lupus anticoagulant test which is basically used for antiphospholipid antibody syndrome. People with SLE may have an association with antiphospholipid antibody syndrome (a thrombotic disorder), wherein autoantibodies to phospholipids are present in their serum. Hence you have got this test done.

When a person is initially negative for the lupus anticoagulant but has an autoimmune disease such as SLE or a mixed antigen (anti-ENA) testing. Anti-dsDNA(double stranded DNA) antibodies are highly specific for SLE and should be done.

I suggest you to get anti-ds DNA antibody test done to confirm the diagnosis.
Further, SLE is a known cause of arthritis. Once we have confirmed that you have this condition, appropriate treatment can be started. You will start feeling better once the right treatment has been started.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Please accept my answer in case you have no follow up query.
Wishing you good health.
Regards.



Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Jasvinder Singh (18 hours later)
Thank you, XXXXXXX 2x neg, anti-ds DNA antibody neg, sorry for not including. what do (these) results mean? what else could be the cause?

"No lupus anticoagulant was detected. Results are consistent
with the presence of one or more factor-specific inhibitors.
Since the dRVVT was within normal limits, the factors in
question are VIII, IX, XI, XII and the contact factors. "
doctor
Answered by Dr. Jasvinder Singh (17 hours later)
Hi,

Thank you for writing back.

The XXXXXXX and dsDNA being negative rules out the possibility of Lupus.

Are you having any spontaneous bleeding episodes from any site of the body?

Please write back with the answer.

Awaiting your reply.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Jasvinder Singh (3 hours later)
1. NO external bleeding, brusing very easy, resently both knee's feel swollen and sore, slight sweeling behind knee's back of legs, blueish veins in area, very sore after laying down?

2. belly feels slighty extended but not sure if it is some wieght gain.

3. hands feet swell sometimes.

4. also last ultra sound showed <1mm polyp or gull stone, was told not too worry about it at this time by VA due to unexplaind left flank lower rib pain 4-5 mnths. they found this while looking for cause of pain, (i have no right side pain)so i dont think gull is a issue. but not sure. they are always very veig.

5. no blood in urine detected last UA? , but the color is always dark, cola?

thank you Doctor,

doctor
Answered by Dr. Jasvinder Singh (20 hours later)
Hello,

As you've mentioned earlier, one or many of the inhibitors of the clotting factors seems to be in play in causing the symptoms you're going through. It makes sense to consult a hematologist for the same and seek treatment. You don't seem to have a spontaneous major blood which itself is a very good sign. I don't think I am worried about the small polyp/gallstone. I sincerely hope that helps. Take care.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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Suffered Jerking Arms,legs, Headaches, Dark Urine. Can Someone Look Into Lab Results And Explain

Hello,
Thanks for posting your query.

I can understand your concern for these symptoms and your laboratory findings. Given your symptoms, there is a high possibility that you are having SLE (joint pains, multiple body aches, myalgia, malar rash, low grade fever, headaches, hematuria causing cola colored urine or proteinuria.

The tests that you have undergone are the lupus anticoagulant test which is basically used for antiphospholipid antibody syndrome. People with SLE may have an association with antiphospholipid antibody syndrome (a thrombotic disorder), wherein autoantibodies to phospholipids are present in their serum. Hence you have got this test done.

When a person is initially negative for the lupus anticoagulant but has an autoimmune disease such as SLE or a mixed antigen (anti-ENA) testing. Anti-dsDNA(double stranded DNA) antibodies are highly specific for SLE and should be done.

I suggest you to get anti-ds DNA antibody test done to confirm the diagnosis.
Further, SLE is a known cause of arthritis. Once we have confirmed that you have this condition, appropriate treatment can be started. You will start feeling better once the right treatment has been started.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Please accept my answer in case you have no follow up query.
Wishing you good health.
Regards.