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Wow – It’s like peeling an onion, so many layers to this. RF and CCP were positive, CRP and SED normal, – Lyme, Bart and CD57 bands ALL negative and now HLA-B27 antigen positive – HLA DR4 says “not detected”. What does this mean?
The only symptoms I have are plantar fasciitis …this blood test scavenger hunt all started by going to the podiatrist for sore feet. Then a positive RF lead to CCP the lead to Lyme and so on and so on.
I have read conflicting info online – “HLA B27 points to AS or Reactive arthritis BUT don’t show positive CCP or RF”
HLDR4 – points to RA, but my test says not detected. Rheumy appointment in October…what the heck do I have brewing? I almost wish I didn’t know all these bloodwork results.
What do you think??Hi,
HLA-B27 is a kind of genetic marker. As such, you have always been HLA-B27 positive and always will be.
“A positive test means HLA-B27 is present. It suggests a greater-than-average risk for developing or having certain autoimmune disorders. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.”
Source: HLA-B27 antigen: MedlinePlus Medical Encyclopedia
Recommended reading: Heredity and Arthritis
Phil
"Unthinking respect for authority is the greatest enemy of truth."
- Albert EinsteinA positive HLA DR4 is associated with chronic, none abx sensitive, lyme arthritus as well as rheumatoid arthritus. There is more detail to it. This article might help
http://www.nejm.org/doi/full/10.1056/NEJM199007263230402#t=article+Conclusions.
I asked my docter for the HLA DR4 test as well, and allready have the results. Unfortenately, i cant interpret the results myself and she will do hopefully at our next appointment.
Succes!
@Karel wrote:
A positive HLA DR4 is associated with chronic, none abx sensitive, lyme arthritus as well as rheumatoid arthritus. There is more detail to it. This article might help
http://www.nejm.org/doi/full/10.1056/NEJM199007263230402#t=article+Conclusions.
Karel, I’m sure your LLMD will have a different opinion.
As the article in the link was written by infamous Allen C. Steere, I wouldn’t consider his opinion as valid for Lyme arthritis sufferer:Lyme arthritis can usually be treated successfully with antibiotic therapy. However, regardless of the antibiotic used and the number of courses given, in some patients the arthritis does not respond to treatment
As Allen Steere is behind IDSA Lyme treatment guidelines which claim that 3 weeks of abx is enough to heal Lyme disease, and the above states that only one antibiotic was used (he uses the word antibiotic in singular) and the”number of courses” is not specified so may mean anything, even 2-4 courses of 3 weeks of abx, the quoted above statement only means that IDSA treatment guidelines are not enough to treat Lyme arthritis in some patients. I think that “some patients” should be changed to “most patients”, and then to “all patients” when Lyme becomes chronic.
I don’t remember when I noticed considerable improvement, but I don’t think there was any within the first 4 months, which would be over 5 courses of 3 weeks of abx. And I was taking a single antibiotic only during the first month, starting with month #2 it was multiple abx.
There’s the light at the end of the tunnel! ILADS treatment works!
Warm wishes,
KrysKrys, thanks for the response. I was not trying to demotivate people from starting or continuing ABX for lyme or rheumatoid arthritus by referrring to the article, but I believe the DR4 could be seen as explantion why ABX doesn’t work as fast as it works for other cases and why your Lyme has turned into arthritus in the first place. Since other studies have, I believe, found a similar relationship, it is in my eyes an important DNA value to help in the explanation. Ok we all know the value of DNA and in general there is no 1 on 1 relationship between having the DNA and having the commonly associated symptoms.
Glad that your lyme arthritus has improved. Just curious, was it diagnosed as lyme arthritus (typically bigger joints, first moving than settling and becoming chronic) or more as rheumatoid arthritus (small joints fingers, toes, symetrically)?
To Doxiemom: I know to little about this all, but if it was that easy all new patients at rheumatologists would have this test done to exclude RA. In other words, no, you can not say that you dont have RA because your HLA DR4 is negative.
@doxiemom2014 wrote:
Wow – It’s like peeling an onion, so many layers to this. RF and CCP were positive, CRP and SED normal, – Lyme, Bart and CD57 bands ALL negative and now HLA-B27 antigen positive – HLA DR4 says “not detected”. What does this mean?
The only symptoms I have are plantar fasciitis …this blood test scavenger hunt all started by going to the podiatrist for sore feet. Then a positive RF lead to CCP the lead to Lyme and so on and so on.
I have read conflicting info online – “HLA B27 points to AS or Reactive arthritis BUT don’t show positive CCP or RF”
HLDR4 – points to RA, but my test says not detected. Rheumy appointment in October…what the heck do I have brewing? I almost wish I didn’t know all these bloodwork results.
What do you think??Hi Doxiemom,
The labs for rheumatic diseases can be confusing at the outset and, in your case, it looks like there may be a predisposition for some overlap of RA and AS or PsA or ReA or inflammatory bowel disease. Having a genetic marker does not mean you will get the disease, but there is potential for this to occur in certain circumstances. Overlaps aren’t uncommon around here, if they do occur and sometimes you will see people posting a signature to say that they have been diagnosed with RA, Lupus and Sjogren’s, for instance. In these scenarios, it’s often described as a “mixed connective tissue disease” (MCTD). Plantar fasciitis is also a common ‘feature’ of the spondylarthritides.
Did you get tested through IGeneX labs for your Lyme or was it standard testing through a lab like Quest? Also, what was the result of your CD57 test, if you don’t mind sharing this? Noted you didn’t get any testing run for mycoplasmas, strep or chlamydias. There are other infectious offenders, too, but these are pretty common ones and quite often found in combination.
The thing is, Brown didn’t see much division between rheumatic diseases. He felt they were ALL caused by infection of one type of another and that the way to treat it was to slowly bring down that pathogen load to train the immune system to be less reactive to the pathogens’ antigen. Am sure you must have read all about this in the book and on the site already, but you are so right that it is a bit like peeling away at an onion and each layer of the onion will be unique to the individual. It’s also worth noting that some infections are highly immunosuppressive, so depending on the type of test run – e.g. an antibody test – if the person’s immune system is compromised, they may not produce enough antibody to test as their body just isn’t recognizing the infection(s) and able to put up a fight. An example was one Mom who posted here for her daughter a couple years ago who suffered from a myriad of rheumatic symptoms and when she got tested for Lyme with more sensitive testing, the results were leaning on the negative side. However, once her daughter started getting treatment for suspected Lyme and she was re-tested again a few months later, her test was very definitely positive. It doesn’t always work this way, but thank goodness for the mother bear who followed her gut instincts.
It may not yet be very clear what you’re “brewing” in terms of a definitive rheumatic diagnosis, but as Brown described in the book, the earlier treatment is begun for any rheumatic disease, the swifter the turnaround before things get too entrenched. I hope you find your answers soon, Doxiemom. Knowledge is power, though, so the more you can learn about all this and your treatment options, the easier it will be to make informed decisions. In the meantime, you might want to sift through some of the posts on what you can do to support your immune function through making dietary changes that can go a long way to helping to reduce inflammatory symptoms (even when inflammation markers appear to be normal).
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