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What Does This Blood Report Indicate?

Posted on Mon, 4 Jan 2016

Question: Hi, I've just gotten my labs back from my rheumatologist, and there are the following abnormal results:sjogrens antibody ss-b 3.6
White blood cell count 13.9
Absolute neutrophils 8938
Absolute lymphocytes 3934
I have arthritis, but have always been negative for RA

Can you help me with a possible reason for these values?
Thank you,
XXXX

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Arthritis

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, I have gone through your history. There are some details missing which I would like to know before advising further.

1. Arthritis can be there when Rheumatoid FActor is negative as well. So we need to look into ANA and Anti CCP antibody. I am not sure if it has been carried out for you yet or not.

2. XXXXXXX B is positive. If you could mention the cut off for it, it would be helpful...Also do let me know about the rest of the ENA profile

3. I would like to know a few more symptoms if you are experiencing:
(i) Dry eyes/dry mouth
(ii) Oral ulcers
(iii) Hair Fall
(iv) Rashes over the face
(v) Any bluish discoloration of the fingers during winters

4. Do you have reports of ESR, CRP?

5. What medications are you taking

Do let me know these queries. Would be happy to sort it out for you

Regards
Dr Naval

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

Follow up: Dr. Naval Mendiratta (10 hours later)

How there,
<1 is negative For sjogrens antibody, mine is 3.6
ANA and C-reactive protein is normal. Sed rate and ESR, as well as Lyme disease and Western blot normal
I do not have dry mouth etc., none of the symptoms of Sjogrens
Have family members with Reynauds, but I do not.
I am taking Tylenol3, Atarax and hydroxicine, took ibuprofen for many years, but developed an ulcer.
About ten years ago I had two
episodes of Alopecia errata, but have not had it since.
Stupid question: I had breast implants 16 years ago, they're both encapsulated and I wonder if my body's immune system is reacting to them?
Thank you, XXXX

Answered by Dr. Naval Mendiratta (13 hours later)

Brief Answer:
Is it sjogrens Syndrome

Detailed Answer:
Good evening XXXX

Well, there can be XXXXXXX B Antibody positivity but without ANA being positive. But if you dont have sicca symptoms( dry eyes/dry mouth) we need not treat you further. We can wait and see if anything develops. Few of the times, the antibody can be falsely positive and may not hold much significance.

Secondly, I am not sure about the arthritis you have as you are not taking any strong medications for it( like methotrexate/leflunomide). You are analgesics and anti inflammatory, so that is one doubt I have on what they had diagnosed for you, and what exactly are they treating it. If you have some previous records you can share them with me. It will help me with more insight on it.

3. Breast implants are a foreign device and they can trigger few reactions in the body. They can give false positive antibodies as well. But since it has been long, I doubt it is causing any of the symptoms now

What is your rheumatologist take on it? I still feel we can observe you for any development of the sjogrens/lupus as you still dont have much symptoms for the disease

hope the information was useful

Do let me know for more queries

Regards
Dr Naval

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