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Dr.Sumanth, Doctor (MD)
Category: Medical
Satisfied Customers: 14592
Experience:  Consultant Pediatrician at Kanchi Kamakoti CHILDS Trust Hospital
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I am a 19 year old female and have recently been diagnosed

Customer Question

Hello, I am a 19 year old female and have recently been diagnosed with ITP due to low platelet count and am taking 75mg eltrombopag. I was referred to a rheumatologist which has diagnosed me with lupus on the basis of the symptoms of ITP, testing positive for antinuclear antibodies, occasional mouth ulcers and a one off red, itchy eye. The rheumatologist has prescribed 200mg plaquinol daily without sufficient tests to treat lupus. I fear i have been misdiagnosed, do you think i should take the medication?
JA: How long have you been using Plaquenil? Has it helped at all?
Customer: I have not started taking it yet because i am uncertain of the diagnosis
JA: Got it. Have you seen a doctor about the ulcers?
Customer: Yes we have, i changed my toothpaste and haven't had a mouth ulcer in a month
JA: Thank you so much for your time. Finally, is there anything else in your medical history you think the Doctor should know?
Customer: I also have a history of veruccas on my feet and have recently been experiencing hair loss along with frequent urgency to urinate, but i do drink a lot of water
Submitted: 13 days ago.
Category: Medical
Expert:  Dr.Sumanth replied 13 days ago.
Hi...Welcome to Just Answer. I am Dr. Sumanth Amperayani. I have 16 years of experience in the field of Medicine at a tertiary care referral hospital. I am currently reviewing your question.Kind regards ***** ***** Sumanth Amperayani
Expert:  Dr.Sumanth replied 13 days ago.
Hello... I understand your concern. I need some more information please.1. Since how long have you had all these symptoms?
2. Are you having any small joint pains like fingers and toes?
3. Is there any stiffness of the spine or shoulder girdle or hip girdle?
4. Are you having any rash any where over the torso?
5. Are you running chronic intermittent fever?
6. Did you suffer from EBV anytime please?
7. Do you have early morning stiffness of joints?
8. Is there any family history of autoimmune disease?
9. Can you upload all the reports which you have in hand please?Please get back to me with the above information so that I can guide you better.Kind regards ***** ***** Sumanth Amperayani
Customer: replied 13 days ago.
1. In november I went for a routine blood test due to small red dots and frequent bruising, my platelets were low (<5) and i was admitted to hospital where i received steroids and immunoglobulin treatment, the platelets dropped again a week later and went on 3 month of steroids to treat ITP. Once this finished, my platelets dropped again and i am now on Eltrombopag long-term. I have had mouth ulcers since i was 10 years old. I have a thin eustachian tube and have frequent issues with my ear but i do swim so that may be caused by that. I had acne and was on long term antibiotics and Roaccutane to treat that which i completed in September 2020. The verrucas h started when i was around 12 but the cleared up when i was 17 and one or two have come back. The need to urinate has been an issue for around 3 month now. Hair loss started about two weeks ago. I also struggle to take a deep breath which has been happening for around a month now.
2. no joint pain.
3. no
4. no
5. no
6, no
7. no
8. My aunt has antisynthese syndrome.
9. Unfortunately, my gp has all my reports
Customer: replied 13 days ago.
okay i can continue talking on here
Customer: replied 13 days ago.
Have I been charged for the phone call
Customer: replied 13 days ago.
Do you have any insight??
Expert:  Dr.Sumanth replied 13 days ago.
I have never accepted any phone call so you will not be charged.
Expert:  Dr.Sumanth replied 13 days ago.
I understand your concern and from your description of symptoms and the proceedings I feel that your treatment schedule is going on in the right path and you need to be on those medications for the auto immunity to be under control.I sincerely ***** ***** I have helped you today!Is there anything else where I can be of assistance to you in this regard please. We can continue here until you are satisfied, simply use the reply box and let me know.Kind regards ***** ***** Sumanth Amperayani
Customer: replied 13 days ago.
Do you have any experience with the drug Plaquinol, is it a safe drug? how will i know if it is working? Will it treat my ITP?
Expert:  Dr.Sumanth replied 13 days ago.
I have regularly used it in many of my adolescent patients.
It is good.
As physicians we always tend to to see the risk benefit ratio and it is patient tailored for each particular patient.
Customer: replied 13 days ago.
Okay thank you, ***** ***** its role in the treatment of lupus?
Expert:  Dr.Sumanth replied 13 days ago.
It is an immunomodulatory drug and it will reduce the inflammation and it will reduce the vasculitis which is going on internally.
Customer: replied 13 days ago.
Thank you for your response, will it subsequently wok to treat my ITP. Do you have any experience with a connection between ITP and lupus?
Customer: replied 13 days ago.
Do my symptoms correlate with lupus symptoms?
Expert:  Dr.Sumanth replied 13 days ago.
In fact I have seen till now two cases in many cases of auto immunity which I have dealt with.
Both of them presented initially with lupus and later during the course of treatment when lupus was in remission they presented with ITP.
Yes it is possible because vasculitis is phenomenon which can present with myriad of symptoms.
But I should agree that coexisting lupus and ITP are rare.
Customer: replied 13 days ago.
Okay thank you, ***** ***** concerned that i had been misdiagnosed as there was not enough of the lupus symptoms to diagnose me with the condition. I understand that many people can be positive for the antinuclear antibodies and thought that my mouth ulcers were normal.
Customer: replied 12 days ago.
Do you have any idea what may have caused either of my autoimmune conditions and do you think there is a possibility they may go into remission
Expert:  Dr.Sumanth replied 12 days ago.
If you are completely without any symptoms and ANA comes positive I would agree with that but in this particular scenario we should think about autoimmunity.
Expert:  Dr.Sumanth replied 12 days ago.
There is a very fair chance that this symptoms will go into remission.