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Positive ANA Blood Test after Remicade

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Crohn's Disease
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Posted 2/5/2016 10:36 PM (GMT 0)
Hi all,

about two and half years ago, I was diagnosed with Drug Induced Lupus from Remicade. Sadly, the Rheumatologist that diagnosed me suffered a heart attack last year and has retired. I saw a different Rheumatologist earlier this week, and he told me that he thinks I never had drug induced lupus and that the side effects I had were just Crohn's. All I can say is after my last Remicade infusion, I started running a fever that evening, and the next day my right big toe and left wrist were very swollen, red, painful, and warm to the touch. I've had Crohn's since 2007 and I had NEVER experienced an arthritis flare like that! My first Rheumatologist ran blood work and I had a positive ANA of >1.1280. Has anyone else here had this happen? The second Rheumatologist also said that Crohn's arthritis can flare up even when the bowels are under control and I always thought the two kind of went together.

Thanks all for your opinions with this!
Posted 2/6/2016 12:50 AM (GMT 0)
I had drug induced lupus [DILE] while on Humira. However, I had a positive ANA and high levels of anti ds-DNA antibodies while on Remicade. The Humira likely pushed me over the edge.

Many people that get Remicade or take Humira, Simponi, etc., develop anti ds-DAN antibodies but they never develop DILE. DILE comes along when one develops 4 of the 11 symptoms associated with lupus. This list includes fever, swelling, fatigue, sun sensitivity, etc. See the entire list here:
www.lupus.org/answers/entry/common-symptoms-of-lupus
Posted 2/6/2016 3:36 AM (GMT 0)
I think you need a new rheumy or at least a second opinion.
Posted 2/6/2016 5:47 AM (GMT 0)
indigo, how long did the toe & wrist swelling last? How long did the fever last?

Positive ANA by itself, or even with the joint swelling, isn't usually enough to diagnose drug-induced lupus. It might be enough to *consider* drug-induced lupus, but I'd expect to see more lupus-related symptoms before saying that the diagnosis is certain.
Posted 2/6/2016 12:17 PM (GMT 0)
Hi,

Sorry you are suffering with is pain. I had Remicade induced Lupus years ago. It affected my joints and was extremely painful. I remember it started in my thumb joint, and the next day was in my shoulder, and jumped from one side of my body to the other. I couldn't lift my arm up high enough to pour water into the coffee maker. I also couldn't get up and down off the toilet or climb stairs without alot of pain. My rheumy told me the only thing to help is 25 mg of prednisone and MTX together. This pain is real. I have had Crohns for 34 years and I do not have arthritis from Crohns. Please get a second opinion.

All the best Julia
Posted 2/6/2016 4:13 PM (GMT 0)
Hi all,

I believe the swelling in my big toe lasted for a few weeks. From there, it moved into my ankle and stayed there for a good 2-3 months. It was so swollen, I couldn't walk or drive and had to use a scooter to get around. And then it eventually moved into my other ankle for a while and it has affected some of my toes. Off and on the past couple of years, I've had fevers, severe fatigue, joint pain and swelling in several other joints, and every now and then, my left ring finger will swell up and stay that way for a month or two. The only thing that really has helped with any of this is prednisone. I've had very small rashes which have looked similar to discoid rashes--however, they do not last long and are not very large, so I don't know if I can even consider those. I am afraid that my first rheumy saw or knew something that this one doesn't and I worry what will happen if these symptoms return in full force. I do have my name on a wait list for another rheumy but I can't see him until January. The old rheumy told me if I ever went back on an anti-TNF, it would be a considerable risk, but the new rheumy told me I could even go back on Remicade and be fine which sounds crazy to me!
Posted 2/6/2016 7:54 PM (GMT 0)
All information I have read says that DILE usually resolves in 1 - 3 months after stopping the medication. A small percentage take 6 - 12 months for it to resolve. Sounds like you have something else going on. Spondyloarthropathy or gout?

I have successfully taken Simponi, an anti-TNF, for 7 years since my DILE.
Posted 2/6/2016 8:51 PM (GMT 0)
When this first started, my first rheumy checked me for gout, and it was negative. He did suspect that I could have possible psoriatic arthritis during one of my appointments. When I told the second rheumy that, he basically brushed it off because I have not been diagnosed with psoriasis. I guess my concern is having something like this happen again, and not having a doctor that believes that something is wrong. I wish the second rheumy would have offered to run new blood panels and x-rays, just to see if there's something else that is going on.
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