Ask the Doctor: Arthritis Can Target Young Men
DEAR DR. DONOHUE: I am a 49-year-old man with a diagnosis of seronegative spondyloarthropathy.
I take sulfasalazine, prednisone and ibuprofen.
In the morning, my hands are swollen.
My eyes are inflamed, and my left eye stays red.
What causes this, and is there a cure?
I am considering taking Humira or Enbrel.
What are their side effects? - M.C.
ANSWER: “Spondylo” refers to the spine, the backbones.
“Arthropathy” is another word for arthritis.
“Seronegative” indicates that blood tests do not show that the arthritis is rheumatoid arthritis.
The most common kind of this variety of arthritis has an equally daunting name, ankylosing spondylitis, which means about the same thing.
I believe that’s what you have.
It’s arthritis of the spine, and it affects relatively young men.
Other joints, like the knees and ankles, often are involved.
The sacroiliac joint, the joint that connects the lowermost spine to the pelvic bones, is practically always affected.
The two SI joints are on the right and left sides of the body, slightly below the top of the buttocks.
Finger swelling is a common sign, as is eye inflammation.
Genes play a big role in this illness.
And the genetic influence is seen in one lab test called HLA-B27.
Almost all with this illness have a positive HLA-B27 test.
Naturally, back pain and stiffness are prominent symptoms.
The stiffness can creep all the way up to and include the neck.
The goals of treatment are keeping the spine as limber as possible, controlling the inflammation and minimizing pain.
The medicines you’re taking are standard for this illness.
How about your eyes?
You should be on eyedrops.
If you are not, see an eye doctor.
“Cure” is too strong a word.
Control, however is possible.
The two drugs you mentioned, Humira and Enbrel, neutralize one of the inflammatory chemicals that stir up all the trouble.
One of them should be considered if present medicines are making no headway.
Both work well. Both have major side effects, as do all effective medicines.
Infections, a small chance of tumors, nerve damage, a decrease in blood cells and liver problems are some of those side effects.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.