[24F] With sharp abdominal pain and positive ANA test

Patient Description

A 24-year-old female has been experiencing sharp abdominal pain for years, with an intensity of 7-8 out of 10. The pain occurs every other day and lasts for hours. There are no known relieving factors. Accompanying symptoms include changes in stool, weight loss, persistent itching primarily on the arms, fatigue, and malaise. The itching has been present for a year without specific triggers. The patient has a positive ANA test and is undergoing evaluation by a specialist. She has an IUD and does not experience menstrual periods. Skin symptoms include dry, flaky skin on the face, acne, dry skin with bumps on the arms and legs, and small pigmentation spots. Joint pain and stiffness occur throughout the day, with a negative rheumatoid arthritis factor. There is a family history of autoimmune diseases. Medical history includes spina bifida occulta, asthma, nabothian cysts, anxiety, PTSD, headaches, and memory problems. Allergies include latex and Prozac. The patient is currently using Mirena as her only medication.

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Arora's Assessment

What might be happening

Your symptoms suggest a complex situation that may involve multiple issues. Here are some possibilities:

  1. Autoimmune Condition: A positive ANA test, along with joint pain, fatigue, and skin changes, could indicate an autoimmune condition like lupus. These conditions can cause widespread symptoms, including joint pain, skin rashes, and fatigue. Further evaluation by a specialist is important.

  2. Chronic Pain and Inflammation: Your sharp abdominal pain and SI joint inflammation might be related to a chronic inflammatory condition. Conditions like endometriosis or fibromyalgia could contribute to widespread pain and fatigue.

  3. Dermatological Issues: The dry, flaky skin and bumps could be related to eczema or psoriasis, which can be associated with autoimmune conditions.

What you can do

Autoimmune Condition:

  • Follow up with a rheumatologist for further evaluation and testing.
  • Keep a detailed journal of your symptoms using MDandMe to track patterns and share with your healthcare provider.

Chronic Pain:

  • Consider consulting a pain specialist or physical therapist for strategies to manage pain.
  • Gentle exercises, like yoga or swimming, may help improve joint mobility and reduce pain.

Skin Issues:

  • Use gentle, fragrance-free moisturizers to help with dry skin.
  • Avoid hot showers and harsh soaps that can worsen skin dryness.

General Health:

  • Maintain a balanced diet rich in fruits, vegetables, and whole grains.
  • Ensure adequate rest and manage stress through relaxation techniques like meditation.

What you should look out for

  • Worsening joint pain or new joint swelling.
  • New or worsening rashes, especially if they spread or become painful.
  • Significant changes in weight or unexplained fever.

Please remember, this information is not a substitute for professional medical advice. It's important to consult with your healthcare provider for a formal diagnosis and treatment plan.

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People Also Ask


What does a positive ANA test indicate?

A positive ANA (antinuclear antibody) test can indicate the presence of an autoimmune disorder, such as lupus or rheumatoid arthritis. However, it is not definitive on its own and must be interpreted alongside other clinical findings and tests.


How can I manage chronic abdominal pain and inflammation?

Managing chronic abdominal pain and inflammation may involve consulting with a pain specialist or physical therapist. Techniques such as gentle exercises, yoga, or swimming can help improve mobility and reduce pain. It's also important to work with your healthcare provider to identify any underlying conditions contributing to the pain.


What are some common skin conditions associated with autoimmune diseases?

Common skin conditions associated with autoimmune diseases include eczema, psoriasis, and lupus-related rashes. These conditions can cause symptoms like dry, flaky skin, bumps, and pigmentation changes.


What lifestyle changes can help manage symptoms of autoimmune conditions?

Lifestyle changes that can help manage symptoms of autoimmune conditions include maintaining a balanced diet rich in fruits, vegetables, and whole grains, ensuring adequate rest, and managing stress through relaxation techniques like meditation. Regular follow-ups with healthcare providers are also crucial for monitoring and managing symptoms.


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