I have low back pain with joint pain, fatigue and high ANA. Please help.

Question

Hello doctor,

My ANA is 1:2560. I am having pain in the lower back, dry mouth, and joint pain in my hands. I feel very fatigued, and I have a history of celiac disease.

Answer 1

Hello,

Welcome to icliniq.com.

The symptoms you are describing are suggesting a connective tissue disease, most likely primary Sjogren's syndrome. It is an autoimmune disease that presents with dryness of the eyes, mouth, dental caries, fatigue, mild to severe joint pains, body aches, and sometimes neuropathy. However, the possibility of other connective tissue diseases cannot be ruled out without further tests. Do you have any other symptoms like photosensitivity, oral ulcers, rashes anywhere, Raynaud's, any muscle weakness, tingling, or numbness of limbs? Some tests that you need to get done are ENA profile (qualitative), C3, C4, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), CBC (complete blood count), LFT (liver function test), KFT (kidney function test), urine analysis. Once you get the above test reports, a final diagnosis can be made, and treatment will be started accordingly. For now, you should start Hydroxychloroquine at 400 mg once at night.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, ENA (extractable nuclear antigen) will help make the diagnosis, and so will the rest of the tests that I advised, like C3, C4, and DCT. Photosensitivity is also seen in Sjogren's syndrome sometimes, as well as mixed connective tissue disease. ENA will help us to determine the type of CTD. Treatment will be similar, with some changes according to your symptoms. Lupus is certainly a possibility that needs to be ruled out.