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Suggest Treatment For Elevated ACA And Complement C3 Levels

Posted on Tue, 26 Sep 2017

Question: I am concerned about some of my latest tests:
Internist ordered - 2/28 Centromere B Antibody - High
ANA Positive
Complement C3 - High

Gastroenterologist ordered 3/21 Colonoscopy biopsies - precancerous with scattered lymphocytes found - doctor requested celiac test - normal

Rheumatologist ordered 6/13 Puffy swelling of left neck to shoulder area
Ultra sound - found lesson - told not to be concerned

8/11 Endocrinologist ordered CT of left shoulder area. Could not do contrast due to Iodine allergy so it had no contrast.
Unremarkable supraclavicular fat pad.

I am aware that this type of fat pad can be lymphoma. With other items, should I be concerned and what would be the next step?

Thanks so much!

Answered by Dr. Prof. Kunal Saha (1 hour later)

Brief Answer:
Further details needed

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. A positive result for Anti-centromere antibodies indicates the possibility of CREST syndrome. The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. Loosely speaking, it is found in a condition called limited systemic scleroderma and occasionally in the diffuse form of scleroderma. C3 is found positive in systemic lupus erythematosus, or lupus, and the mentioned condition is a variant of the same.

This does not correlate with the possibility of lymphoma that you have mentioned. I would therefore need to ask the exact complaints that made you visit a doctor and the condition for which the mentioned tests were prescribed. Based on your inputs I should be able to suggest the further steps.

I would await your response. Let me know if I could help further.

Regards

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

Follow up: Dr. Prof. Kunal Saha (2 hours later)

I already know that I have CREST. I have had it for 20 plus years. This is the first time the Complement C3 has been high. I was having joint swelling and the neck shoulder soft tissue puffiness and swelling initially. Rheumatologist referred me to the internist for further evaluation on the soft tissue issue. Then the X-ray, ultrasound and CT were done by the doctors that I noted originally. The lesion was identified as an ill defined lesion 7x20x9mm in the AP, transverse, and longitudinal dimension in the left supraclavicular region. This was the finding on ultrasound. A CT without contrast was done due to my iodine allergy. The result was an unremarkable fat pad. However, I continue to have the puffiness that seems to be enlarging and at times causes discomfort between the shoulder and neck. I am taking no medication for the problem.

Answered by Dr. Prof. Kunal Saha (20 minutes later)

Brief Answer:
Does not seem to be a cause for concern

Detailed Answer:
Thanks for the clarification. Let me assure you that the mentioned presentation does not seem to correlate with lymphoma. Irrespective of the fact that it is an unremarkable fat pad, it is not without the presence of widespread lymphadenopathy (enlarged lymph nodes) that you would need to be worried about problems like lymphoma.

You do not need any medication for this. However, you should get your thyroid profile checked in case it has not been checked already

Regards

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

Follow up: Dr. Prof. Kunal Saha (14 hours later)

My thyroid function is fine. The endocrinologist has ordered blood work after taking dexamethason. Checking adrenal function and Cushings. Is there anything else that should be checked?
Thanks for your help!

Answered by Dr. Prof. Kunal Saha (9 hours later)

Brief Answer:
Let your doctor go ahead step by step.

Detailed Answer:
Thanks for writing back.

I do not see the requirement of any specific tests. Let your doctor go ahead step by step.

Regards

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