After last remicade infusion, my daughter's finger tips turned purple. Doctor said it was vasculitis.(infusion was done faster this time) ANA test was order and came back positive 1:360 with a homogenous/speckled pattern. All the information I find is related to Lupus. My daughter never had this test done before so there is nothing to compare with. I know remicade can give you lupus like symptoms, but she does not have any symptoms. She is not having a flare right now. Vasculitis signs disappeared 24 hours later. I will ask her pediatrician at next appointment. But I want to prepare with some questions.
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Anybody familiar with ANA & Crohn's
- Thread starter araceli
- Start date
Something similar happened with my daughter (non-crohns) - I'm sorry, I'm going to be a bit vague because it happened a couple of years ago.... One of her fingers suddenly began to give her a bit of pain and was stiff. She didn't remember hurting it but as she plays soccer and taekwon do, it wouldn't be unusual to be hurt in the middle of a play/match and not really remember... but, wouldn't go away... Went to pedi and her ANA was very slightly elevated, ped told me it can indicate lupus but not necessarily. Referred her to rheumo, lots of tests done and it turned out to be calcification from a past injury (I think...) - in any case, although the ANA was slightly elevated, it was not high enough to indicate lupus. However, the rheumo did say that when an auto-immune disease is present in a family, it's not unusual for other family members to have slightly higher ANA but that this does not mean it will progress to anything more.
(I'm in a bit of a rush now but, later on, I'll try to find the thread I had on this and see if I had more info at the time...)
(I'm in a bit of a rush now but, later on, I'll try to find the thread I had on this and see if I had more info at the time...)
Second the seeing a Rheumo
Crohn's can have vasculitis as an EIM or it can be a disease on its own or part of something like lupus etc...
A Rheumo is the best doc to help you figure that out.
DS had vasculitus as an EIM of crohn's prior to remicade .
No ANA blood was done since his crohn's was also not in remission at that point.
Good luck
Crohn's can have vasculitis as an EIM or it can be a disease on its own or part of something like lupus etc...
A Rheumo is the best doc to help you figure that out.
DS had vasculitus as an EIM of crohn's prior to remicade .
No ANA blood was done since his crohn's was also not in remission at that point.
Good luck
- Location
- Northern California, USA
It's complicated and depending on her overall clinical picture other tests may need to be done to clarify the meaning of that particular result.
Normally someone with an elevated ANA and symptoms of autoimmune disease would be evaluated by a rheumatologist.
You could ask for a referral to one for further evaluation. I doubt your pediatrician will have much detailed information for you.
A brief review of the research lit suggests that an ANA level of 1:640 or greater is considerably more predictive of autoimmune disease (like Lupus) than lower ANA levels such as the 1:360 value you mentioned.
Normally someone with an elevated ANA and symptoms of autoimmune disease would be evaluated by a rheumatologist.
You could ask for a referral to one for further evaluation. I doubt your pediatrician will have much detailed information for you.
A brief review of the research lit suggests that an ANA level of 1:640 or greater is considerably more predictive of autoimmune disease (like Lupus) than lower ANA levels such as the 1:360 value you mentioned.
Don't panic over an elevated ANA. It can mean many things and not necessarily lupus. Sometimes there is no explanation for an elevation and it will return to normal on its own. I would definitly get an appt with a rheumatologist.
The way my Rheum at Mayo Clinic described ANA is that some healthy people will have elevated levels of ANA and have NO SYMPTOMS OF ANYTHING. In people with lupus or other autoimmune issues, ANA can be completely normal. The ANA test is old, and has been proven to be confusing and sketchy at best. That being said, when I had drug-induced lupus from Humira, I had a "weak positive" ANA test. I was not diagnosed with drug-induced lupus just based on that, however. I also had extreme fatigue, fevers, joint pain, and a slight butterfly rash on my cheeks.
I spend a few hours doing research and found out that about 49% of crohn's patients who take remicade will show positive for ANA with high titers after a while. also about 20% will show positive for anti histones or something like that without having any lupus like symptoms. It is recommended to stop remicade. She will see the Doctor in a week and I guess more test will be order. I have seen signs of vasculitis in her hands again so either she is developing another autoimmune disease or her body is trying to fight remicade. At this point I don't know. We are tapering prednisone right know and hoping for the best.
Make sure to take photos of the vasculitis and at the beginning and how it progresses and resolves .
DS had vasculitus due to unresolved inflammation .
Good luck at the Gi .
If you need to switch to humira ask for a script for lidocaine to add to the shot .
DS had vasculitus due to unresolved inflammation .
Good luck at the Gi .
If you need to switch to humira ask for a script for lidocaine to add to the shot .
We just got back from Pediatrician, actually it was his assistant, he had an emergency. She said not to worry about ANA results being positive since her complements(ch50 and c3,c4) are good. That is very common for Hispanic people to show positive. (she is only half Hispanic.) I ask her about remicade and positive ANA and she was not aware of that. We are still tapering the pred and everything is going well. About the vasculitis after remicade, next infusion will be slower. Next step is going to be colo/endo.