Dr. Zeng Guosen reply Internal Medicine Question - Page 2

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Preventing HLA-B27 Gene Transmission: Options for Future Generations

How to prevent the inheritance of the HLA-B27 gene to the next generation? Hello Doctor, I am a 26-year-old male who has been suffering from ankylosing spondylitis since I was 17. I am concerned about the HLA-B27 gene being passed on to my future children, which could cause them ...


Dr. Zeng Guosen reply Internal Medicine
1. Currently, there is no method to prevent the inheritance of the B27 gene to the next generation. 2. Techniques such as chorionic villus sampling or amniocentesis, along with PGS and Ultra PGD, may be able to address the presence of a baby with the HLA-B27 gene. This involves t...

[Read More] Preventing HLA-B27 Gene Transmission: Options for Future Generations


Should My Son Continue Taking Fish Oil for Ankylosing Spondylitis?

Can I continue taking fish oil? Hello Dr. Tseng, my son is 21 years old and has been diagnosed with ankylosing spondylitis for nearly four years. Initially, he was only taking Celebrex (he tried Voltaren but it was ineffective). Over the past year, he has added two capsules of Sa...


Dr. Zeng Guosen reply Internal Medicine
The normal range for platelet count is approximately 150,000 to 400,000. Your son's platelet count of 210,000 to 290,000 is actually within the normal range, so there is no need to worry. 1) In healthy individuals who are not taking antiplatelet or anticoagulant medications,...

[Read More] Should My Son Continue Taking Fish Oil for Ankylosing Spondylitis?


Understanding Persistent Low-Grade Fever in Teenagers: Causes and Solutions

Elevated body temperature? Hello, my daughter is 14 years old and recently her body temperature has been between 37.5 to 38 degrees Celsius. Previously, her temperature was mostly around 36.6 degrees. She does not have any discomfort, and when her temperature reaches 38 degrees, ...


Dr. Zeng Guosen reply Internal Medicine
Hello, previously my body temperature was around 36.6°C, but recently it has been between 37.5°C and 38°C. If it's not due to my menstrual cycle and I'm not feeling unwell, it shouldn't be related to the weather. I recommend seeing a pediatric infectious disease sp...

[Read More] Understanding Persistent Low-Grade Fever in Teenagers: Causes and Solutions


Understanding Elevated Alkaline Phosphatase Levels: Causes and Concerns

Alkaline phosphatase Recently, my alkaline phosphatase level was 132, with the normal range being 25-130. I have been taking red yeast rice due to high cholesterol; could this affect the alkaline phosphatase levels? Would dental implants with bone grafts and the use of a regenera...


Dr. Zeng Guosen reply Internal Medicine
Elevated alkaline phosphatase levels usually warrant consideration of liver, biliary, and bone issues. If there are no symptoms and the levels are only slightly elevated (2 times the normal value), and if the GOT, GPT, CA 19-9, and alpha-fetoprotein are all normal, there is no ne...

[Read More] Understanding Elevated Alkaline Phosphatase Levels: Causes and Concerns


Should I Continue Taking Celebrex for Ankylosing Spondylitis?

Should I continue taking Xarelto? Hello Dr. Tseng, I am a patient with ankylosing spondylitis. I am currently undergoing stable treatment with two tablets of Celebrex daily, and my inflammatory markers are within the normal range. My current symptoms only include about one hour o...


Dr. Zeng Guosen reply Internal Medicine
The user has been taking the medication continuously for 26 days, but feels that there has been no improvement in morning stiffness and back pain. It is recommended to return for an evaluation to determine if the medication is ineffective, in which case a change in medication may...

[Read More] Should I Continue Taking Celebrex for Ankylosing Spondylitis?


Understanding Morning Stiffness and Pain in Ankylosing Spondylitis

Is this morning stiffness (and pain) a symptom of ankylosing spondylitis? Hello Dr. Tseng, both my son and I have been diagnosed with ankylosing spondylitis by rheumatologists, but I find it quite peculiar that our experiences of morning stiffness are completely different. When I...


Dr. Zeng Guosen reply Internal Medicine
Morning stiffness in ankylosing spondylitis refers to the stiffness experienced upon waking and moving, whether bending forward or arching backward. The severity of stiffness varies among individuals, but it typically improves after a period of activity. If your symptoms are rela...

[Read More] Understanding Morning Stiffness and Pain in Ankylosing Spondylitis


Understanding Sacroiliac Joint Issues: Is It Always an Autoimmune Disease?

Ankylosing spondylitis 1. The patient recently underwent an X-ray examination due to lower back pain, which revealed structural damage to the sacroiliac joint. The doctor suspects ankylosing spondylitis, but blood tests returned negative for the associated gene, with inflammatory...


Dr. Zeng Guosen reply Internal Medicine
1. Issues with the sacroiliac joint are not solely caused by autoimmune diseases; differential diagnosis is necessary. 2. Generally, back pain associated with ankylosing spondylitis responds well to treatment; if the response is poor, other causes of back pain should be consider...

[Read More] Understanding Sacroiliac Joint Issues: Is It Always an Autoimmune Disease?


Do Allergies Affect Symptoms of Ankylosing Spondylitis?

Can allergies affect the symptoms of stiffness? Hello Dr. Tseng, my son is 20 years old and has both ankylosing spondylitis and allergy issues. He is currently taking two tablets of Celebrex daily for ankylosing spondylitis, but he still experiences morning stiffness for about an...


Dr. Zeng Guosen reply Internal Medicine
If a person has severe allergies that lead to irregular daily routines, it may affect the stability of autoimmune diseases. Mild symptoms typically do not have such an impact. Based on your description (morning stiffness lasting about 1 hour and an ESR frequently elevated to 40-5...

[Read More] Do Allergies Affect Symptoms of Ankylosing Spondylitis?


Can Long-Term Use of Salazopyrin Cause Permanent Hair Loss?

Does taking Salopecia for an extended period cause hair loss side effects that prevent the restoration of original hair volume even after discontinuation? Hello Dr. Tseng, my son is 20 years old and was diagnosed with ankylosing spondylitis at the age of 17. He started taking two...


Dr. Zeng Guosen reply Internal Medicine
Hello, (1) hair loss is more related to individual constitution, and hair loss due to SSRIs is quite rare. (2) If it is indeed caused by SSRIs, discontinuing the medication can lead to recovery. It is recommended to return for a follow-up and discuss with the attending physician....

[Read More] Can Long-Term Use of Salazopyrin Cause Permanent Hair Loss?


Can Side Effects of Salazopyrin Develop After Over a Year of Use?

Can the side effects of Seroquel occur after taking it for more than a year? Hello Doctor, I am a patient with ankylosing spondylitis and have been taking Celebrex (celecoxib) twice a day for over a year. Yesterday, I experienced tinnitus for about 3-4 hours, and today I feel diz...


Dr. Zeng Guosen reply Internal Medicine
The side effects of medications are rarely observed to occur after one year. It is recommended to first consult an otolaryngologist for an examination. If no issues are found and symptoms persist, it is advisable to return for a follow-up and discuss with a rheumatologist. Thank ...

[Read More] Can Side Effects of Salazopyrin Develop After Over a Year of Use?


Is Febuxostat a Better Alternative to Allopurinol for High Uric Acid?

Consultation on Uric Acid Lowering Medications Hello Doctor, I have been taking allopurinol for a long time due to high uric acid levels. Recently, during a company-mandated health check at a designated clinic, the physician there mentioned that allopurinol places a greater burde...


Dr. Zeng Guosen reply Internal Medicine
As long as it can lower uric acid and has no side effects, it's considered a good medication. Currently, there is no research indicating that Febuxostat is better than Allopurinol. If uric acid levels are stable, it is advisable to continue the current medication without swi...

[Read More] Is Febuxostat a Better Alternative to Allopurinol for High Uric Acid?


Understanding Lower Abdominal Pain: Causes and When to Seek Help

Lower abdominal pain? I have been experiencing a dull ache and some bloating in my lower abdomen since last night. I vomited once around noon, which provided some temporary relief, but the discomfort returned shortly after. Is it normal to feel a heartbeat around my navel area?


Dr. Zeng Guosen reply Internal Medicine
There are many causes of abdominal pain, and it requires a specialist for differential diagnosis. If the situation is urgent, please go to the emergency room; otherwise, you can visit a gastroenterology outpatient clinic. Thank you!

[Read More] Understanding Lower Abdominal Pain: Causes and When to Seek Help


Head Injury After Falling from Height: When to Seek Medical Attention

Fell from a height and struck the head? This morning, while engaging in high-altitude sports, I lost my grip due to fatigue and fell from a height. Although there was a soft mat below, I hit the lower right side of my head near my ear upon landing. There were no external injuries...


Dr. Zeng Guosen reply Internal Medicine
Head trauma should be classified under neurosurgery. If there are symptoms or concerns, it is advisable to seek medical attention. Thank you.

[Read More] Head Injury After Falling from Height: When to Seek Medical Attention


Understanding Chills and Shaking: Possible Causes and When to Seek Help

Chills and shivering? Recently, I suddenly felt chills and shivering, which lasted for about an hour, followed by mild nausea and a small amount of vomiting. After that, I suddenly felt fine. Since this has never happened to me before, I would like to ask what the possible diagno...


Dr. Zeng Guosen reply Internal Medicine
Feeling cold and shivering can sometimes be a precursor to a fever, but there are other potential causes as well. If a fever is present, you may want to consult an infectious disease specialist for differential diagnosis. If there is no fever, it would be advisable to see a famil...

[Read More] Understanding Chills and Shaking: Possible Causes and When to Seek Help


Does Ankylosing Spondylitis Increase Risk of Low White or Red Blood Cells?

Does ankylosing spondylitis lead to low white blood cell or red blood cell counts? Hello Dr. Tseng, I am a patient with ankylosing spondylitis, 20 years old, and I have been diagnosed with ankylosing spondylitis for 3.5 years. I am currently undergoing stable treatment. I would l...


Dr. Zeng Guosen reply Internal Medicine
Ankylosing spondylitis is not a common disease, and leukopenia or anemia may occur in some patients. Chronic inflammation over time can potentially lead to anemia. It is recommended to follow up with your physician for differential diagnosis. Thank you.

[Read More] Does Ankylosing Spondylitis Increase Risk of Low White or Red Blood Cells?


Interactions Between Salazopyrin and Lybrel in Uveitis and Adenomyosis

Contraceptive pill issues I have uveitis and adenomyosis. I would like to know if there are any interactions between Salmeterol and Lopinavir.


Dr. Zeng Guosen reply Internal Medicine
There is no information found regarding interactions between Salmeterol and Lopinavir. It is advisable to consult a pharmacist when obtaining medication. Thank you.

[Read More] Interactions Between Salazopyrin and Lybrel in Uveitis and Adenomyosis


Assessing Severity: Understanding Your Joint Pain and Treatment Options

Mild or severe? Mild or severe? Celebrex (celecoxib) 200 mg, taken once in the morning and once in the evening, has become ineffective. Currently, I am experiencing pain in my knee joints, temporomandibular joints, finger joints, and both shoulder joints. I have difficulty squatt...


Dr. Zeng Guosen reply Internal Medicine
There are many differential diagnoses for joint pain. If the symptoms persist and the response to medication is poor, it is advisable to return for a follow-up appointment sooner rather than waiting for 28 days. Thank you.

[Read More] Assessing Severity: Understanding Your Joint Pain and Treatment Options


Understanding Abdominal Masses: Causes and Concerns

Abdominal mass? I would like to ask the doctor, today I suddenly noticed a small lump on the right side of my navel, about the size of a one-centimeter round ball. It hurts when I press it lightly, and it also hurts when I apply more pressure. I'm not sure what the issue cou...


Dr. Zeng Guosen reply Internal Medicine
A friend online mentioned that an abdominal mass could be a sign of various conditions, ranging from skin lesions to intra-abdominal tumors. It is recommended to consult a gastroenterologist for a proper evaluation and diagnosis. Thank you.

[Read More] Understanding Abdominal Masses: Causes and Concerns


Managing Dizziness and Appetite Loss After Mild Stroke in Seniors

Consultation for family members? Hello, doctor. My father is 61 years old. Recently, he has been feeling dizzy every day. He was hospitalized in the neurology department, and the examination results showed a mild cerebral infarction, carotid artery atherosclerosis, and elevated b...


Dr. Zeng Guosen reply Internal Medicine
The user has reported that their blood pressure and blood sugar levels are well controlled after taking medication, but they still feel dizzy, indicating that there may be other unresolved issues. It is recommended to return for a follow-up appointment with a neurologist, who wil...

[Read More] Managing Dizziness and Appetite Loss After Mild Stroke in Seniors


Should You Repeat Allergy Testing After 5 Years? Understanding Changes in Allergens

Is it necessary to repeat the allergen testing for the same allergens that were tested five years ago? Hello Dr. Tseng: I am 21 years old and have had an allergic constitution since childhood. When I was 16, I underwent an allergen test (M25-130-Z MAST ALLERGY) at Chang Gung Memo...


Dr. Zeng Guosen reply Internal Medicine
Over 90% of individuals with chronic allergies cannot identify the cause. Even though allergens may change over a span of five years, MAST ALLERGY testing for 36 allergens still does not alter the treatment strategy. Thank you.

[Read More] Should You Repeat Allergy Testing After 5 Years? Understanding Changes in Allergens


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