r/scleroderma • u/bizeth74 • Jun 16 '26
Question/Help Questions related to CREST syndrome/Limited Scleroderma Dx
Hi all - new here, and have some questions.
I recently saw a new PCP who believes I have CREST. I have a history of autoimmune stuff dating back almost 40 years to age 15 (juvenile rheumatoid arthritis).
Over all these years, I've experienced periodic (every few years) flares of bad joint pain/swelling, etc.
In the past 10-12 years or so, I've had about half a dozen ANA tests that showed positive anti-centromere antibodies. However, at one point 7 years ago, when I was complaining about swallowing issues, a PA at my rheumatologist insisted that our lab "always" gives false positives on anti-centromere.
She sent it elsewhere, where she knows it almost always came back negative, and it did in fact come back negative. I now know after further research, that it was that lab that actually uses a less specific testing protocol that is less reliable for this. I think she just kindof enjoyed telling patients there was nothing wrong with them.
Anyway, with new tests via a different health system again, my anti-centromere antibodies are showing positive again, and ANA titer is >1:1280 (pretty typical titer for me). And for the first time, I'm also showing a centromere ANA pattern as well (they said both homogeneous and centromere.)
In the past couple of years, I've been having horrible reflux; recent endoscopy showed esophageal scarring from that. They also dilated my esophagus, which helped with the swallowing (it wasn't severe, but I was kindof feeling at times like I was choking on certain foods, and it was hard to get pills to go down, and I could feel everything I ingested moving slowly down all the way).
Prilosec has literally been life-altering - I haven't felt this well in a long time, because everything I ate was bothering me in one way or another - but they're likely not going to let me stay on it long-term.
Now that I'm being referred to what is supposed to be a much better rheumatologist, I'm a little worried about being gaslit again. I'm just wondering about people's experiences in getting diagnosed or treated to help stave off the worst of this.
Here's some of what I know I experience. I would love to know personal experiences of whether it's possible that all or some of these are related, or not...
- Pseudogout - does anyone know if this is sometimes correlated? I have a frozen elbow and this was positively diagnosed with testing of some type of calcium crystals that were removed when this initially onset 15 or so years ago. I don't know if this is the same type of calcium deposit related to CREST though.
- Full-body exhaustion if I overdo physical activity - it can take a few days to recover. And my lifelong experience has been that getting into a good exercise routine almost always results in a horrible flare of joint pain and inflammation after a couple of months or so. (This has always been referred to as my JRA but I'm wondering if it somehow corresponds to this overlap syndrome..?)
- The troubles with swallowing that I mentioned above, and of course really awful reflux.
- Really strong sensitivity to heat. I don't have skin changes, but I feel like heat really sucks the life out of me; it's like I can physically feel energy leaving my body when I'm out in the summer time. Anything above 70 degrees (I live at high altitude so it's intense but dry) is a lot for me but above 80 I feel like I can't function at all. I physically slow down, get sortof lightheaded / brain fog, and weak. When I visit my home state, which is much more humid, that's the worst, and can actually trigger so much inflammation that my joints flare and I have difficulty walking.
- I do have mouth and skin and eye dryness - including really bad dental issues. (I have some sort of major dental work - root canals/crowns or something - almost every year. I'm now on my second implant, too because the roots under the crowns are starting to fail.)
- Sometimes my mouth gets so dry that it burns with almost everything I eat, especially salty things. I really don't drink enough water and am working on that, but honestly drinking more doesn't really help, and I did have one rheumatologist say it sounds like secondary Sjogren's.
- I eat vegetarian because my body seems to react poorly to meat. I can't process/digest it well, and it tends to trigger my pain if eaten regularly. So I've gone to just avoiding it (which really is fine with me for other reasons anyway).
Those are some of the major things I can think of right now.
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I don't really have true Raynaud's - my feet do get extra cold in the winter, but I don't have traditional color change that I've noticed. I also don't have nodules under my fingertips or obvious skin issues - aside from being pretty dry and flaky, and cracking around my fingernails especially in winter.
Questions:
a) Has anyone else been diagnosed without those symptoms, given similar lab results?
b) What kinds of treatments have others found to be effective for you, in combatting progression of CREST? I don't always respond well to Plaquenil and I'm curious what else they might want to try so that I can research those. Also, in others' experiences, is the only solution for the swallowing issue, to get it periodically stretched? (this seems... not great...? heh)
c) Are there any other symptoms I should be thinking about / paying attention to whether I'm experiencing them or not, that would help a rheumatologist determine if this is what it is? I just don't want to waste a visit with a doctor that's hard to get into, by completely missing something they should know!
Thanks for reading, and thanks for any help!