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What Causes Neck Pain And Stiffness, Hand Joint Pain, Swelling And Numbness?

Posted on Mon, 14 Dec 2015

Question: Hi, I have a hi positive ANA and negative ENA panel, severe neck pain and stiffness, hand joint pain and swelling and numbness in my hands that come and go. I have had a history of UTIs and a few times of skin rashes in the last 3 years. Can it be Lupus or Fibromyalgia?

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Is it Lupus

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your query and would like to ask you a few more details to see where the diagnosis is heading:

1. Do you experience any other symptoms like hair fall/oral ulcers/dry eyes/dry mouth?

2. When you say swelling in the hands, is it the joints or you feel your hands are puffed up?

3. Any time you noticed rash over the face??

4. Do your rashes disappear itself or you have to take some medication?

5. How strong are your ANA Titres?

6. Do you feel you have been increasingly forgetful or irritable or been having lot of headaches?

7. Did they check your ESR levels??

DO let me know these queries. Would like to see where the disease is heading to confirm if it is lupus or something else

REgards
Dr Naval

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

Follow up: Dr. Naval Mendiratta (2 hours later)

Thank you very much for your response.

1. Do you experience any other symptoms like hair fall/oral ulcers/dry eyes/dry mouth? I have experienced hair loss, mouth ulcer (twice which took a month to go away) in the past year.

2. When you say swelling in the hands, is it the joints or you feel your hands are puffed up?Joints are swollen

3. Any time you noticed rash over the face?? I had rash 3 years ago and had to use medication for 2 months for it to go away. Ever since I use a special moisturizing only but other than that no rash.

4. Do your rashes disappear itself or you have to take some medication? I had to use medication

5. How strong are your ANA Titres?1:320

6. Do you feel you have been increasingly forgetful or irritable or been having lot of headaches? Yes, forgetfulness and lots of headache

7. Did they check your ESR levels?? yes it is normal

Answered by Dr. Naval Mendiratta (22 hours later)

Brief Answer:
Is it lupus

Detailed Answer:
Good evening

Sorry for the late response, was caught up in a long duty

Thanks for your response. Well considering the symptoms, it does go more in favor of lupus than fibromyalgia. Considering rashes, oral ulcers, muscle aches, with history of joint swellings and hair fall plus a strong ANA, we cant deny Lupus

Fibromyalgia can be a secondary thing which can happen with a lot of autoimmune problems.

Lupus can have many variants and treatment will depend on the organ involvement. I hope they have checked your other labs and no organ has come out to be a problem. Probably you have a minor organ lupus and would benefit from starting Hydroxychloroquine. It s a relatively safe tablet and will give you relief from your symptoms and prevent the progression of ANA as well.

I wouldnt ignore these symptoms

I hope the information was useful

Do let me know for more queries. would be happy to help out

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naval Mendiratta (33 hours later)

Hello Dr Naval,

Thank you very much for your response.

I have checked ENA panel and all of them are negative. Does this mean that the disease is mild and/or hasn't progressed yet?
Can someone have lupus with negative ENAs.

My doctor have talked about Hydroxychloroquine to me too. Do I need to take it for a long time?

Best regards

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Role of hydroxychloroquine

Detailed Answer:
Good evening

Well, it is a good thing your ENA is negative. At least it gives us a safe feeling that it wont involve your internal organs.

But there is always a chance the disease may evolve later on. From the history of lupus, it is known that it does evolve upto 3 years and if it still doesnt the chances of the disease evolving come down to minimal. Do get your ENA profile checked once a year or 6 months.Lot of patients do have ENA negative Lupus when it is limited to minor organs only that is the skin/joints.

Hydroxychloroquine is a safe drug which slows down the intensity of lupus. SO i would recommend you can take this. But yes, you have to take it at least for few years . Normally we start at 200 mg twice daily and reduce it one tablet after 3 months.

As long your disease remains under control with one drug, we are good at it. Over time we keep reducing the frequency of it. ( probably after a period of 3 years)

Hope the information was useful

Do let me know for more queries

Regards
Dr naval

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

Follow up: Dr. Naval Mendiratta (8 hours later)

Thank you very much for your response. Really appreciate your time and giving me the details.

Best regards.

Answered by Dr. Naval Mendiratta (3 hours later)

Brief Answer:
Further responde

Detailed Answer:
Good evening

I am glad I could be of some assistance.

Hope i have solved your query

Take care and wish you a healthy life ahead

Regards
Dr Naval

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