Do Ankylosing Spondylitis Patients Face Higher Long COVID Risks?
Do patients with ankylosing spondylitis have a higher risk of developing long COVID after contracting COVID-19? Hello Doctor, I am a patient with ankylosing spondylitis and currently undergoing stable treatment with Vectra and Celebrex. I would like to ask if patients with ankylo...
Dr. Zeng Guosen reply Internal Medicine
Hello, the medication you are taking does not affect the prognosis, and patients with ankylosing spondylitis are not more likely to experience long-term effects from COVID-19. Thank you for your question.[Read More] Do Ankylosing Spondylitis Patients Face Higher Long COVID Risks?
Impact of COVID-19 Vaccine on Ankylosing Spondylitis: What to Know
The impact of COVID-19 vaccines on ankylosing spondylitis? Hello Doctor, I previously asked you about the worsening of my ankylosing spondylitis condition after receiving the first dose of the BNT vaccine (where my medication became ineffective in controlling inflammation levels ...
Dr. Zeng Guosen reply Internal Medicine
Hello, the COVID-19 vaccine does not necessarily worsen ankylosing spondylitis; however, it is true that approximately 5% of patients with autoimmune rheumatic diseases may experience instability in their condition after vaccination. The reasons for this are unclear, and the degr...[Read More] Impact of COVID-19 Vaccine on Ankylosing Spondylitis: What to Know
Understanding Elevated Liver Enzymes: Should You Worry?
Liver enzyme levels are normal but higher than the values from three years ago? Hello, doctor: I am 40 years old and a carrier of hepatitis B. I have been undergoing regular abdominal ultrasounds and blood tests every six months at Renai Hospital in Taipei. Each time, the results...
Dr. Zeng Guosen reply Internal Medicine
Hello, the AFP level is 2.42, ALT is 35, and AST is 27, all of which are within the normal range, indicating no inflammation. You may consider testing for hepatitis B viral load for a comprehensive assessment. You can compare all the series of follow-up data; they should remain w...[Read More] Understanding Elevated Liver Enzymes: Should You Worry?
Understanding Ankylosing Spondylitis: Treatment Options and Patient Concerns
Ankylosing spondylitis Dear Doctor: I am a patient with ankylosing spondylitis, diagnosed for 2.5 years, and I am currently 18.8 years old. I have been managing my condition with NSAIDs and have been unable to discontinue them. I would like to ask the following questions: 1) Gen...
Dr. Zeng Guosen reply Internal Medicine
1) Biological agents tend to be more effective and are easier to achieve stable drug withdrawal. 2) For a 19-year-old, there are no specific recommendations; a general chest X-ray and electrocardiogram are sufficient. 3) It does not necessarily increase. 4) A temporary paus...[Read More] Understanding Ankylosing Spondylitis: Treatment Options and Patient Concerns
Managing Ankylosing Spondylitis: Medication, Exercise, and Inflammation Concerns
Medication usage and exercise? Hello Doctor: I am a patient with ankylosing spondylitis. 1) I have been taking Secukinumab for six months, and it has been effective in controlling my condition. However, recently, despite unchanged medication, my pain and inflammation levels have ...
Dr. Zeng Guosen reply Internal Medicine
Hello, online friend. 1) Autoimmune diseases have a characteristic of fluctuating symptoms, which may not always be related to medication issues. 2) Vaccines can activate autoimmune diseases or trigger immune abnormalities in approximately 5%-10% of cases. 3) The impact of food i...[Read More] Managing Ankylosing Spondylitis: Medication, Exercise, and Inflammation Concerns
Understanding Ankylosing Spondylitis and Its Impact on Immunity
Ankylosing spondylitis and immunity? Hello Doctor, I am currently 18.7 years old. I have already received the first dose of the BNT vaccine and am considering self-paying for the first dose of a biologic agent and the second dose of the BNT vaccine. I would like to ask you: 1) Ho...
Dr. Zeng Guosen reply Internal Medicine
1) Some biologic agents have effects, while others do not; please consult the attending physician. 2) Autoimmune diseases can have fluctuating conditions, and vaccines may also have an impact, so it is important to consider the actual situation. 3) Generally, in ankylosing spondy...[Read More] Understanding Ankylosing Spondylitis and Its Impact on Immunity
Understanding Side Effects of Celecoxib: Gastrointestinal Concerns and More
Side effects of Xeljanz? Hello Doctor: I am a patient with ankylosing spondylitis, currently 20 years old. I started taking Celebrex a year ago, and recently, four days ago, I began experiencing bloody stools. The colorectal surgeon diagnosed it as hemorrhoids and has prescribed ...
Dr. Zeng Guosen reply Internal Medicine
Hello, netizen. 1) Yes, but Celecoxib is one of the anti-inflammatory pain medications with relatively low bleeding side effects. 2) An ALT level of 34 is within the normal range, so there is no need to worry as long as it is within normal limits. 3) Generally, the CRP test can d...[Read More] Understanding Side Effects of Celecoxib: Gastrointestinal Concerns and More
Evaluating the Efficacy and Risks of Biologics for Ankylosing Spondylitis
Biologics (additional inquiries) The questions below, starting with an asterisk, were previously asked to Dr. Tseng, and I appreciate Dr. Tseng's response on January 25: "It is effective, and I recommend continuing the medication and adjusting the dosage after some time...
Dr. Zeng Guosen reply Internal Medicine
Hello, the medical guidelines suggest a sequence of medications for treatment, taking into account their side effects and benefits. The principle is to use anti-inflammatory and analgesic medications as the first line of treatment. The consideration of biologics should be discuss...[Read More] Evaluating the Efficacy and Risks of Biologics for Ankylosing Spondylitis
Understanding Ankylosing Spondylitis: MRI Findings and Future Implications
Nuclear vibration report issues? Hello Doctor: My son is 19 years old. A year and a half ago, he started experiencing pain in the sacroiliac joint, and recently, through MRI and other examinations, he was diagnosed with ankylosing spondylitis. The following English portion is the...
Dr. Zeng Guosen reply Internal Medicine
Hello, bone marrow edema indicates a localized inflammatory response. Regardless of whether it is treated or stabilizes on its own, bone marrow edema will resolve, making it reversible. Once healed, there will be residual signs of previous inflammation on the bone, known as subch...[Read More] Understanding Ankylosing Spondylitis: MRI Findings and Future Implications
Understanding Immunomodulators for Ankylosing Spondylitis Patients
Regarding immunomodulators? Hello Doctor: I am a patient with ankylosing spondylitis. I have undergone an MRI, which showed no inflammation at L4/5 and L5/S1, but there is inflammation in the sacroiliac joint. I have some questions for you. First: Is the sacroiliac joint consider...
Dr. Zeng Guosen reply Internal Medicine
User 1: The sacroiliac joint and the spinal joints are classified as axial joints, not peripheral joints. User 2: Only in the case of inflammation of the sacroiliac joint, it is generally recommended to take non-steroidal anti-inflammatory drugs (NSAIDs), and there are also biolo...[Read More] Understanding Immunomodulators for Ankylosing Spondylitis Patients
Effective Treatment Strategies for Ankylosing Spondylitis in Young Patients
Treatment methods My son is currently 18 years old and began experiencing symptoms of ankylosing spondylitis two years ago, with a diagnosis made one year ago. I have the following questions: 1) For the past six months, my son has been taking two capsules of Celebrex (200 mg ea...
Dr. Zeng Guosen reply Internal Medicine
1) It is effective, and it is recommended to continue taking it while adjusting the dosage over time. 2) Do not consider switching to immunomodulators for now. 3) Only if CRP/ESR remains high after medication can one apply for biologics. 4) SIMPONI is not suitable for children un...[Read More] Effective Treatment Strategies for Ankylosing Spondylitis in Young Patients
Impact of COVID-19 Vaccines on Inflammatory Markers in Patients with Ankylosing Spondylitis
COVID-19 Vaccines and Inflammatory Markers Hello Doctor: I am a patient with ankylosing spondylitis and have been taking Secukinumab for a year. My inflammatory markers were under control, but after receiving the first dose of the BNT vaccine on September 27, I noticed an increas...
Dr. Zeng Guosen reply Internal Medicine
1) In outpatient experience, there have been cases where inflammation markers worsened after receiving the COVID-19 vaccine, with literature reporting approximately 5%. 2) This has been observed in various rheumatic patients and with different vaccines. 3) The duration of the imp...[Read More] Impact of COVID-19 Vaccines on Inflammatory Markers in Patients with Ankylosing Spondylitis
Understanding Dizziness and Fainting: Heart Rate Concerns in Teens
Cardiac issues, dizziness, and fainting? I am currently 17 years old and my heart rate reaches 190 to 200 beats per minute after about 5 minutes of exercise. Is this considered normal? I feel very dizzy and short of breath. I went to the hospital for an ECG, which was normal, and...
Dr. Zeng Guosen reply Internal Medicine
Hello, if your heart rate reaches 190 to 200 beats per minute after about 5 minutes of exercise, it indicates that the intensity is too high for you. It is recommended to adopt a gradual approach to increase your exercise intensity. If no issues are found, consider consulting a s...[Read More] Understanding Dizziness and Fainting: Heart Rate Concerns in Teens
Should We Change Medications for Ankylosing Spondylitis Management?
Should the medication be changed? Hello Doctor: My child (born June 2003, currently 18 years and 6 months old) developed ankylosing spondylitis in June 2019 (symptoms only included sacroiliac joint pain, with no morning stiffness). However, he was only diagnosed with ankylosing s...
Dr. Zeng Guosen reply Internal Medicine
1. At that time, the patient was unable to stabilize their condition with the current medication, so it may be worth trying the new medication recently; if it proves ineffective, we can switch back. 2. It may be worth trying the new medication recently; if it proves ineffective, ...[Read More] Should We Change Medications for Ankylosing Spondylitis Management?
Understanding Ankylosing Spondylitis: Managing Inflammation and Treatment Options
Ankylosing spondylitis has fluctuating levels of inflammation markers? Doctor: A young male, 18 years old, was diagnosed with ankylosing spondylitis at the end of 2020 and started taking Celebrex (200 mg). Below are the CRP (mg/dL) / ESR (mm/hr) and medication records: 2020/11/...
Dr. Zeng Guosen reply Internal Medicine
1. BNT may lead to instability in certain immune inflammatory diseases. 2. If the ESR is significantly elevated but there are no symptoms, it is advisable to monitor the situation; further investigation should be conducted if abnormalities arise. 3. Disease control includes: ...[Read More] Understanding Ankylosing Spondylitis: Managing Inflammation and Treatment Options
Can You Take Large Pills with Food? Tips for Easier Swallowing
Medication issues Is it okay to take large pills with food if they are difficult to swallow?
Dr. Zeng Guosen reply Internal Medicine
Medications are designed for specific administration times; some should be taken before meals, some after meals, and others during meals. Some tablets may be too large and can be split or crushed, while others must be swallowed whole. It is advisable to consult a pharmacist or th...[Read More] Can You Take Large Pills with Food? Tips for Easier Swallowing
Missed the Golden Treatment Window for Rheumatoid Arthritis?
Did rheumatoid arthritis miss the golden period for treatment? Hello, doctor. For the past two to three years, I thought my joint pain was due to aging, but I only learned over a year ago that I have rheumatoid arthritis. Unfortunately, it has already caused damage to my foot joi...
Dr. Zeng Guosen reply Internal Medicine
Hello, regarding the treatment of rheumatoid arthritis, the earlier the better. The first year after onset, or even the six months prior to the onset, is considered the golden period for treatment. However, as long as a diagnosis is confirmed, it is never too late to pursue aggre...[Read More] Missed the Golden Treatment Window for Rheumatoid Arthritis?
Understanding Rheumatoid Arthritis: Eye Symptoms and Immune System Links
Clinical symptoms of rheumatoid arthritis? Hello, Doctor. I started experiencing dryness and pain in my left eye last year. Last month, I suddenly developed scleral inflammation in my right eye. After seeking medical attention, my condition is currently stable. Recently, I underw...
Dr. Zeng Guosen reply Internal Medicine
Hello, dry eyes and scleritis can be manifestations of rheumatic diseases affecting the eyes. If the rheumatoid factor is positive, it is recommended to consult a rheumatologist for differential diagnosis, as rheumatic diseases do not always present initially with joint symptoms.[Read More] Understanding Rheumatoid Arthritis: Eye Symptoms and Immune System Links
Understanding Stiff and Swollen Finger Joints: Causes and Solutions
Stiffness and swelling in the finger joints? Hello Doctor: Last year in late autumn, I noticed stiffness in my finger joints upon waking up, but it was mild, so I didn't pay much attention to it. Recently, however, the frequency has increased, and almost every day my fingers...
Dr. Zeng Guosen reply Internal Medicine
Hello, experiencing stiffness in the finger joints upon waking, pain in the index finger, swelling in the fingers, positive urine occult blood test, and hair loss should not be ignored, but there is no need to panic. Please seek medical evaluation, as there are many potential cau...[Read More] Understanding Stiff and Swollen Finger Joints: Causes and Solutions
Moderna Vaccine Concerns for Patients with Contrast Agent Allergies
Allergic Reactions to Contrast Agents and Issues with the Moderna Vaccine Hello Doctor, I have a history of heart surgery and I am currently on medication for hypertension and hyperlipidemia. I am very concerned about the risk of thrombosis, which is why I chose to receive the Mo...
Dr. Zeng Guosen reply Internal Medicine
Hello, it is indeed important to be cautious about allergic reactions to contrast agents when considering mRNA vaccines (including Moderna and Pfizer-BioNTech). For the AstraZeneca vaccine, aside from known allergies and related contraindications, it should generally be safe to a...[Read More] Moderna Vaccine Concerns for Patients with Contrast Agent Allergies