December 4, 2005

Dr. Gott: Many Disorders Connected to Protein Abnormalities

By PETER GOTT, M.D. Newspaper Enterprise Association

Dear Dr. Gott: I've been diagnosed with abnormal protein. I'm told there is no treatment for this condition. I've been treated for arthritis for years, and my doctor tells me it may be the protein causing the pain in my joints. This protein also makes my thyroid show up overactive in all blood tests. Can you tell me what part this condition plays in my overall health picture?

Dear Reader:: I'm not sure what you mean by abnormal protein because there are many medical conditions associated with excess or abnormal proteins in the body. For example, multiple myeloma, a form of blood cell cancer, causes elevated blood proteins that can plug up the kidneys, leading to renal failure.

Also, chronic illness can lead to production of an abnormal protein, called amyloid, that may cause organ damage. Finally, most autoimmune disorders, such as lupus and rheumatoid arthritis, are marked by unusual proteins in the blood.

From your brief description, I'd say you probably have an autoimmune disease that is affecting your joints and your thyroid gland. This could be a combination of diseases, such as rheumatoid arthritis and hyperthyroidism, or it might be a single malfunction of protein synthesis affecting many organs. Using selective blood tests, your doctor should be able to clarify your problem.

Obviously, your health will be affected by any protein abnormality; therefore, it's important for the physician to establish a diagnosis that is more specific than "abnormal protein." Once the abnormality has been suitably categorized, you can receive appropriate treatment.

For instance, therapy for rheumatoid arthritis includes anti- inflammatory drugs; treatment of hyperthyroidism requires anti- thyroid medication (or radioactive iodine), and management of lupus often necessitates cortisone. Usually, once the underlying disorder is brought under control, the consequences of the abnormal proteins improve and patients return to relatively good health.

I suggest you discuss these issues with your physician, who will explain your disease and recommend treatment.

Dear Dr. Gott: I'm scheduled to have a bunionectomy shortly, and I have a tendency to develop keloids. What, if any, complications could the keloids cause to impede the healing process?

Dear Reader:: Keloids are excessive scar formation. Their cause is unknown. Keloids can follow injury or surgery, but the extent of keloid formation is impossible to predict. In my experience, keloids rarely appear on the feet. Therefore, it's probably safe to have your bunion operation.

Remember that keloids, being scars, do not interfere with healing: They're actually part of the healing process. When a keloid causes symptoms (such as pain or skin irritation), it can be surgically removed.

Write Dr. Gott c/o United Media, 200 Madison Ave. 4th floor, New York, NY 10016