Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Was AS, now RA?

I've had AS for about 8 years but kept symptoms minimal by eating a strict low carb diet. The last few years, only peripheral joints are hurting. The Rheumatologists at Cleveland Clinic decided that I no longer have AS but now have RA. Does this make any sense? Ever heard of that?

And now the diet is not enough to control the pain but it is devastating if I eat carbs.

Scott

Hello, Scott:

NOT POSSIBLE; these diseases are VERY DIFFERENT and it is either RA or it is not and it is either AS or it is not. If You are HLA B27 positive it is AS. If You are HLA DR1 or DR4 in addition to B27, it is possible to have both RA and AS but this is very very rare.

YOU know what to do for AS for the level of control You have and although You could treat AS and RA together...the doctors cannot, well not REALLY treat the diseases rather they can chase symptoms around.

It all depends upon You and what kind of body You wish to leave to Yourself in Your old age.

HEALTH,
John

My personal opinion is that doctors don't have all the answers. My personal advice is to stick to the exercise, diet, and meds that work the best for you. I am positive for a whole bag of "diseases" that have never fully manifested. It seems more likely that your AS is currently in remission and you also have RA, which is not in remission, but I'm not a doctor.

Peace

hard to say if its AS, RA, or both? i've heard of a few people here being dx'ed with more than one autoimmune disease, but i've never heard of one becoming the other. sometimes doctors will think one, then as symptoms become more distinct, another. or its possible its the AS, peripheral symptoms are common with AS too. i've read and heard people say that in RA, the peripheral joints are usually inflamed symmetrically, while in AS or spondys in general, the problems are assymmetrical (like right achilles heel, left knee or both achilles heels but one a lot worse than the other). i fall into this assymmetrical pattern very much so, but also have the SI and spinal issues...........so i think all those things are possible, but one disease morphing into another, i've just never heard of that before.

Hi Scott,
I'm going to say that it is more likely they were either wrong about your diagnosis before, or are wrong about it now. It's possible to have both, but I haven't heard of going from one disease to the other... in the case of AS to RA at least. Maybe ask your doctors to double check to see if you have one of the recently discovered genes for AS??? (can someone help me out here by naming them?) Okay I found two, ARTS1 and IL23R, I think there is one more too. ERAP1 ?

One area that this can happen though...
I went from JRA (juvenile rheumatoid arthritis) to AS because I had the HLA-B27 gene and started to fuse. It started out as JRA because I'm RF+ and only had problems with extremities for the first 7 years. This 'transformation' from JRA to AS is well documented on the net, and it says a large percentage of males with JRA go on to have AS, so I probably didn't have a wrong diagnosis in the beginning. Several years later they changed JRA to JIA (Juvenile Idiopathic Arthritis) because JRA had nothing (or little) to do with the Rheumatoid Arthritis found in adults. I'm still RF+ though.

New gene links:
http://spineblogger.blogspot.com/2010/01/breakthrough-in-gene-therapy-for.html
http://www.sanger.ac.uk/about/press/2007/071021.html

Is it possible that the Rheumatologists at the Cleveland Clinic have changed your diagnosis from AS to RA - meaning that they believe that your earlier AS diagnosis was incorrect? It is unlikely that they are trying to say that your AS was cured or that it somehow morphed into RA. While they share some similarities, AS and RA are different disease processes. It can be difficult in the early stages to differentiate between different forms of inflammatory arthritis. If, after 8 years, your symptoms predominate in the peripheral joints, it is statistically more likely to be RA.

As John said, it is possible to have both diseases, but that is extremely rare.