Immune System Issues: Symptoms and Concerns Explained

Immune system issues

Hello, Doctor Gao.
I have a few questions to ask you, and I appreciate your help.

1.
At the beginning of August, I developed a urinary tract infection and took antibiotics for two weeks.
The symptoms disappeared, and I thought I was cured, so I didn't return for a follow-up.
However, a week later, I started feeling uncomfortable again.
After returning to the clinic, the doctor said it had progressed to acute prostatitis.
After about two weeks of treatment, my urinalysis results were normal, but two weeks later, I still felt a bit uncomfortable and returned for another visit.
The doctor mentioned there was a slight inflammation and prescribed another week of antibiotics.
During this time, I accidentally tested positive for gonorrhea and received an antibiotic injection from the doctor.
After a week of treatment, I had blood tests for seven sexually transmitted infections, all of which were negative, and a urinalysis a week later showed no inflammation.
2.
After completing the treatment for gonorrhea, I suddenly experienced intense heat and itching around the anal area.
After consulting with the doctor, I was told it was anal ulceration and was advised to apply medication and take sitz baths.
However, I still occasionally feel heat in the anal area, without any abdominal pain or diarrhea.
I consulted a colorectal surgeon, who examined my anal area and found everything to be normal.
The doctor suggested it might be due to autonomic nervous system dysfunction or anxiety.
I also experienced conjunctivitis during this time, which resolved after 4-5 days of treatment.
3.
In my last visit to the urology department, I informed the doctor about the above occurrences.
Upon hearing about my conjunctivitis and urinary tract infection, the doctor asked if I had joint pain, suggesting it could be recurrent arthritis.
However, he later said that since the first two symptoms had improved, I shouldn't worry too much.
The day after the doctor's visit, I noticed a slight stiffness in my left knee, but there was no pain.
A week later, I found no improvement and went to an orthopedic clinic, where I was prescribed anti-inflammatory medication, but it didn't help much.
Today, I feel a bit uncomfortable while walking.
I saw a different doctor who said my knee was swollen with fluid buildup and helped drain the excess fluid and gave me an injection.
However, my wrist and ankle have been experiencing sudden pain over the past few days, while my fingers and toes are not swollen.
Currently, I only have discomfort in my joints.

I would like to ask the doctor if, considering all the above symptoms, I might have recurrent arthritis or rheumatoid arthritis? Thank you.
I have an appointment on Friday to see a rheumatologist and plan to have blood tests done.
Do you think that is necessary, or am I just overthinking things? Thank you.

You, 20~29 year old female. Ask Date: 2023/10/04

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
I believe there is a high possibility of reactive arthritis, especially considering your age and the occurrence of acute prostatitis along with unexplained joint effusion and swelling.
I recommend that you consult a rheumatologist nearby.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, is here to assist you.

Reply Date: 2023/10/04

More Info

Hello! Thank you for reaching out with your detailed questions regarding your health concerns. Based on the symptoms you've described, it seems that you are experiencing a complex interplay of issues that may involve your immune system, but let's break it down step by step.

1. Urinary Tract Infection and Prostatitis: It’s common for urinary tract infections (UTIs) to lead to complications such as prostatitis, especially if the infection is not fully resolved. The fact that you were treated with antibiotics and your symptoms initially improved is a good sign. However, recurrent symptoms can indicate that the infection was not completely eradicated or that there may be another underlying issue.

2. Anal Discomfort: The sensation of heat and itching in the anal area, along with the diagnosis of anal ulcers, can be quite uncomfortable. It’s important to follow your doctor's recommendations for treatment, including topical medications and sitz baths. If the symptoms persist, it may be worth exploring other potential causes, such as skin conditions or even dietary factors that could be contributing to irritation.

3. Joint Pain and Inflammation: Your concern about the possibility of recurrent arthritis or rheumatoid arthritis is valid, especially given your recent symptoms of knee discomfort and swelling. The fact that you have experienced joint pain in your wrist and ankle, along with the swelling in your knee, raises the question of whether there is an inflammatory process at play.
- Reactive Arthritis: Given your history of infections (like the UTI and gonorrhea), it’s possible that you could be experiencing reactive arthritis, which can occur after infections. This type of arthritis typically affects the joints and can cause pain and swelling.

- Rheumatoid Arthritis: While rheumatoid arthritis is a possibility, it usually presents with more systemic symptoms, including prolonged stiffness in the morning and symmetrical joint involvement. However, it’s important to rule it out, especially if you have a family history of autoimmune diseases.

4. Need for Further Testing: Your decision to see a rheumatologist and get blood tests is a prudent one. Blood tests can help identify markers of inflammation (like ESR and CRP) and specific antibodies that may indicate autoimmune conditions.
5. Anxiety and Stress: It’s also worth noting that anxiety and stress can exacerbate physical symptoms, including pain and discomfort. The mind-body connection is powerful, and managing stress through relaxation techniques, therapy, or lifestyle changes can be beneficial.

In conclusion, while your symptoms could suggest a potential autoimmune or inflammatory condition, it’s essential to gather more information through medical evaluations. The upcoming appointment with the rheumatologist will be crucial in determining the next steps. They may recommend imaging studies or additional blood tests to clarify the diagnosis.
In the meantime, keep track of your symptoms, including any changes in pain levels, swelling, or new symptoms. This information will be valuable for your healthcare provider. Remember, it’s always better to address these concerns sooner rather than later, especially when it comes to potential autoimmune issues. Take care, and I hope you find relief soon!

Similar Q&A

Understanding Immune System Disorders: Causes, Symptoms, and Treatments

What is immune system dysfunction? What causes such diseases? How can they be treated?

Dr. Yang Kunde reply Rare Disease
Dear readers: 1. The scope of immune system disorders is broad, generally referring to immune deficiency and hyperactive immune responses. Immune deficiency primarily manifests as increased susceptibility to infections, while hyperactive immune responses are typically expressed...

Understanding the Dangers of a Compromised Immune System

Hello: The body's autoimmune system being compromised can lead to various conditions, such as the development of vitiligo on the skin. What are the potential drawbacks of having a weakened autoimmune system? Thank you!

Dr. Zeng Guosen reply Internal Medicine
Hello: Abnormalities in the immune system can lead to dysfunction in every system of the body, such as an increased susceptibility to infections resulting in sepsis, as well as liver and kidney dysfunction, skin erythema, leukoderma, blisters, and itching, among other symptoms. S...

Understanding Immune System Issues: Symptoms and Diagnostic Insights

Hello doctor, I started experiencing chills and fever on the night of August 4, 2022. The next day, I visited an ENT specialist who diagnosed me with a common cold. I took medication for three days, and while I felt somewhat better, the fever returned. After that, I occasionally ...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your inquiry. In your test results, the presence of IgM antibodies indicates an acute infection, so it is important to consider Toxoplasmosis, Cytomegalovirus (CMV), and Epstein-Barr Virus (EBV). Toxoplasmosis is caused by a parasite known as Toxoplasma, whil...

Understanding Immune System Disorders: Insights for Patients and Families

Hello, Doctor Gao. I am a family member of patient #207861. Thank you very much for your response. I apologize for wanting to follow up with a question regarding the immune system. Based on the following lab results: An: 86, RPR: Non-reactive, RF: <10.0, CRP: 0.098, IgG: 877.2...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your inquiry. I believe there is no autoimmune disease present. Although your ANA is slightly elevated, an ANA titer of 1:160 or higher is more significant. Additionally, your physician has arranged for a very detailed immunological assessment, so an ANA tite...