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Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) overlap?
Autoimmune Diseases | Last Active: 24 minutes ago | Replies (14)Comment receiving replies
Hi @rdf56, your medical history and current symptoms sound very similar to mine, although I can’t tolerate JAK inhibitors.
May I ask whether you’ve ever had an ACTH stimulation test for adrenal insufficiency? If so, the results might suggest switching from cortisol to hydrocortisone replacement.
Also, do your fingernails look consistent with classic nail psoriasis? And when was the last time you had ELISA testing for lupus or any vascular/autoimmune workup?
I’m asking because some of my symptoms became significantly worse after I was also diagnosed with APS (antiphospholipid syndrome). In my case, it seemed to contribute to both uncontrolled inflammation and accumulated joint damage.
Replies to "Hi @rdf56, your medical history and current symptoms sound very similar to mine, although I can’t..."
@swalex
Hi, Swalex. Thank you for your comments. The doc does the ELISA testing every 6 months. It's due again in July. My adrenals are completely non productive and the ACTH test has been done repeatedly, with 7am cortisol levels. It's never in the normal range. The endocrinologist said we don't even need to test anymore. I was initially put on cortisol instead of prednisone, but I felt like my day was "too uneven" if that makes sense. I'd take the morning dose and feel like crap before the next dose, so since prednisone is long acting, I've been able to experience a more even keel, so to speak. My biggest issue with any of the biologics or JAK's is that I catch literally anything that comes down the pike and I've got 5 grandkids under the age of 5, so someone is always germy & I refuse to wear masks around them. If my kids need me I'm there. This means I have to constantly alter my prednisone doses because I get sick a lot. Obviously, I've been on and off steroids since I was a teen, but it was the Budesonide for colitis that finally did me in on that score. I'm off it now as it happens that the Xeljanz has put it under control pretty decently. The nail pitting & black lines showed up a couple of years ago, and there are nail issues on my feet as well. It wasn't until my joints at the figure tips started to get bad rapidly, that the rheumy suggested the PsA thing and said it didn't matter that I hadn't shown the skin symptoms, which she said could still show up eventually. O joy! There's so much crossover between all these diseases, that it's no longer much of a surprise to me when something else shows up. I actually had an internist once suggest when I was only 16, that my allergies asthma, uveitis, and lupus rash was all due to the "trauma" of being adopted as a 3 day old infant! Who knows, maybe he was right! But I pay attention to everything and I'm a good researcher, as I spent 15 years in Medical Malpractice (plaintiff work), before 3 small kids and a job became too much and I retired early. I always ask a lot of questions and plenty of docs find that tiring I'd bet. Just yesterday, a podiatrist kept trying to cut things short! I've got a lot of patience for doctors. They're just people and they can't do it all. Plenty of them get sick too and they also tend to be lousy patients. Lol. I'm lucky to have all mine and I've got quite a few. Good luck to you. Take care
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@swalex
Hi, what is your diagnosis and your symptoms?
I have systemic sclerosis/scleroderma (skin thickening) with inflammatory arthritis manifested by swollen joints with thinning scaly skin over joints and purple skin striations. These changes to the joints have happened recently, and my rheumy is not sure if this is a new PsA, or SSc progression. Dermatomyositis test came in negative. I have just started Humira injections. Too early to see much improvement. I am trying to understand what worked for other patients with these symptoms.