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Raynaud's Phenomenon
So, I was recently "diagnosed" with Raynaud's after a recent (4 days ago) doctor visit. I made an appointment to see him after I woke up one morning and my toes were covered in blue and purple spots (that the doctor said was "mild frostbite"). He ran a series of blood tests for things like Leukemia, Lupus, and Schleroderma, and all of the results came back with good news. He's now referring me to a cardiologist for a heart echo, or something like that. I don't know how to spell it.
I've been experiencing unusually cold feet and fingers for over a year now. That's as far back as I can remember. I'm only 17. Sometimes my fingers and toes will turn blue and purple and red, obviously, from Reynaud's. I get light headed kind of easily. I used to have really bad acne and I was on Isotretinoin (Accutane) for seven months straight. My skin is very dry from that still. I'm losing weight because I've been dieting a little and excercising more. I weigh 128 pounds. Sometimes I have a hard time swallowing very dry foods without water or something. My grandmother has a similar throat issue. I sometimes have chest pains, though not recently. My chest would ache for about fifteen minutes. (I'm trying to name some unexplained physical abnormalities I've dealt with.) A few years ago a large, mysterious lump appeared on my face. It went away, but my facial lymph nodes were swollen to great sizes for a few months afterwards after being treated with a tetracycline. ..As much as I hate saying it; I'm may also have some sort of "mental disease" like depression or bipolar disorder, or something. Everyone in my immediate family does, but I don't admit believe in them. ...It's obvious I have Raynaud's, but what else can I have? Is anything sticking out at anyone? Anything I could be missing, or is this just something I have for an unexplained reason..? I don't understand. There has to be some reason I have this, right?
I've been experiencing unusually cold feet and fingers for over a year now. That's as far back as I can remember. I'm only 17. Sometimes my fingers and toes will turn blue and purple and red, obviously, from Reynaud's. I get light headed kind of easily. I used to have really bad acne and I was on Isotretinoin (Accutane) for seven months straight. My skin is very dry from that still. I'm losing weight because I've been dieting a little and excercising more. I weigh 128 pounds. Sometimes I have a hard time swallowing very dry foods without water or something. My grandmother has a similar throat issue. I sometimes have chest pains, though not recently. My chest would ache for about fifteen minutes. (I'm trying to name some unexplained physical abnormalities I've dealt with.) A few years ago a large, mysterious lump appeared on my face. It went away, but my facial lymph nodes were swollen to great sizes for a few months afterwards after being treated with a tetracycline. ..As much as I hate saying it; I'm may also have some sort of "mental disease" like depression or bipolar disorder, or something. Everyone in my immediate family does, but I don't admit believe in them. ...It's obvious I have Raynaud's, but what else can I have? Is anything sticking out at anyone? Anything I could be missing, or is this just something I have for an unexplained reason..? I don't understand. There has to be some reason I have this, right?
Just a quick FYI...
Anti-Jo Antibodies are present in 20-30% of patients with polymyositis (I said dermatomyositis, and it can help diagnose that, but it's more specific for polymyositis). Anti-Mi-2 is a better test for dermatomyositis.
Cardinal characteristics of polymyositis: Interstitial lung disease, arthritis, mechanic's hands, raynauds phenomenon, myositis.
Anti-Jo Antibodies are present in 20-30% of patients with polymyositis (I said dermatomyositis, and it can help diagnose that, but it's more specific for polymyositis). Anti-Mi-2 is a better test for dermatomyositis.
Cardinal characteristics of polymyositis: Interstitial lung disease, arthritis, mechanic's hands, raynauds phenomenon, myositis.
I'm a medical student and I'm going to guess your doctor tested you for ANA which has high sensitivity for the disease. Do you have any idea what count you got? You should always get a copy of your lab tests so you can understand what they mean. If your doctor did not explain them well enough, you should ask him/her for more information.
Here's the thing... it would makes sense that since you were negative for ANA, he probably wouldn't test you for the high specificity antibodies for Lupus (Anti-dsDNA & anti-Sm antibodies) or scleroderma (Anti-Scl is specific for scleroderma).
Still, you have some symptoms of Sjögren syndrome which maks me wonder if he tested you for the Anti-Ro antibody (SS-A) or Anti-La (SS-B) which are specific for that disease. Even if you are ANA negative, you could still be positive for these!! You said you had a lump on your face... was it actually on your face or was it under your jaw? Your "swollen lymph nodes" could have been enlarged salivary glands. Sjögren’s Syndrome could be the cause behind your difficulty swallowing dry foods if you aren't producing enough saliva.
Now on to another final thought... antibodies are specific for myositis (polymyositis, dermatomyositis) do not have sensitive tests, just specific ones right now. He probably did not test you for Anti-Jo-1 antibodies. Adults with dermatomyositis may experience weight loss or a low-grade fever, have inflamed lungs, and be sensitive to light. Dermatomyositis’ cardinal symptom is a skin rash that precedes or accompanies progressive muscle weakness. The rash looks patchy, with bluish-purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, heels, and toes. Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations, and there may be swelling in the affected areas. Dermatomyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus.
My answer... don't give up. This is not in your head. You do not have a mental disease (you HAVE actual symptoms).
Hope this helps. Email me with further questions (***@****)
Here's the thing... it would makes sense that since you were negative for ANA, he probably wouldn't test you for the high specificity antibodies for Lupus (Anti-dsDNA & anti-Sm antibodies) or scleroderma (Anti-Scl is specific for scleroderma).
Still, you have some symptoms of Sjögren syndrome which maks me wonder if he tested you for the Anti-Ro antibody (SS-A) or Anti-La (SS-B) which are specific for that disease. Even if you are ANA negative, you could still be positive for these!! You said you had a lump on your face... was it actually on your face or was it under your jaw? Your "swollen lymph nodes" could have been enlarged salivary glands. Sjögren’s Syndrome could be the cause behind your difficulty swallowing dry foods if you aren't producing enough saliva.
Now on to another final thought... antibodies are specific for myositis (polymyositis, dermatomyositis) do not have sensitive tests, just specific ones right now. He probably did not test you for Anti-Jo-1 antibodies. Adults with dermatomyositis may experience weight loss or a low-grade fever, have inflamed lungs, and be sensitive to light. Dermatomyositis’ cardinal symptom is a skin rash that precedes or accompanies progressive muscle weakness. The rash looks patchy, with bluish-purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, heels, and toes. Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations, and there may be swelling in the affected areas. Dermatomyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus.
My answer... don't give up. This is not in your head. You do not have a mental disease (you HAVE actual symptoms).
Hope this helps. Email me with further questions (***@****)
Have your doctor check out your thyroid- I was diagnosed with bipolar disorder- however the entire time I was hypothyroid which can cause depression. It may also explain the trouble swallowing food.
MEDICAL PROFESSIONAL
Hello,
It definitely sounds like raynaud’s diasease.All other differentials have mostly been ruled out.The other possibility could be a peripheral vascular disease caused due to some atherosclerotic plaque leading to disruption of blood supply to the peripheries.so that is the reason that your doctor has asked you to consult a cardiologist.
Raynaud’s disease is a vascular disorder that affects blood flow to the extremities which include the fingers, toes, nose and ears when exposed to temperature changes or stress.
I feel that a consultation of a physician will be the best.Other causes of cold and blue peripheries like diabetes, stroke, multiple sclerosis and underactive thyroid also have to be ruled out.
Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional doubts.
It definitely sounds like raynaud’s diasease.All other differentials have mostly been ruled out.The other possibility could be a peripheral vascular disease caused due to some atherosclerotic plaque leading to disruption of blood supply to the peripheries.so that is the reason that your doctor has asked you to consult a cardiologist.
Raynaud’s disease is a vascular disorder that affects blood flow to the extremities which include the fingers, toes, nose and ears when exposed to temperature changes or stress.
I feel that a consultation of a physician will be the best.Other causes of cold and blue peripheries like diabetes, stroke, multiple sclerosis and underactive thyroid also have to be ruled out.
Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional doubts.
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