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Forum Name: Rheumatology Topics

Question: HI complement C3, back pain, albuminuria


 alexussl - Wed Nov 19, 2008 9:13 pm

Hi there,
I hope you can help with this question. My doc found protein in a routine urine test 10 months ago. I have repeated the tests, had ultrasounds, and a 6 month follow up with no change. I went to a Nephrologist, who repeated all the tests, albumin in urine is up form 10 to 18.3 now. He said the kidneys were fine, and mentioned that the rheumatoid factor serum came back High. the complement c3 is 1.98. All other blood work came back fine, and low blood pressure. I am seeing a urologist in a couple of weeks for a prolapse bladder and overactive bladder.

I am concerned about the back pain I have had for almost a year now. When I get up in the morning, my back is very tight, and takes about 15-20 minutes to loosen up and straighten out. Very painful. Same thing if I lay flat on my back or stomach even for a few minutes. If I twist the wrong way while lying down, feels like my back is locked, and have to get up and straighten out (same as when you get a toe cramp). I slipped in the stairs 2 years ago and bruised my tail-bone. 8 years ago my doc mentioned I had mild scoliosis.

I am only 27, active, otherwise healthy and would love to get this whole thing resolved. Can the back pain, and abnormal blood work be connected?
thank you
 Tom Plamondon PA-C - Wed Dec 17, 2008 4:14 pm

User avatar Thanks for writing in and sorry about the delay.
Main information given was proteinuria, high complement (c3) level, and low back pain with morning stiffness. Any connection between the three?

One of several causes of proteinuria is systemic lupus erythematosis which can present with arthritc pain. This more often occurs in women. May present with fatigue, muscle aches, rash (eg butterfly rash on the face). The eyes, heart, lungs, brain, and musculoskeletal system may also be involved. Some labs like ANA and anti-CCP would help. I would suppose a low complement count to be more indicative of autoimmune disorder.

A high complement level with low back pain and stiffness may be assosciated with an inflammatory condition. In a young man with low back morning stiffness, worse with inactivity, anklyosing spondilytis (AS) should be considered. Occurs in young men. This condition should improve with activity. Pelvic xray may help see inflamatory changes in the sacroiliac joints (sacroilitis). Probably want lumbar xray too. A late finding would be the "bamboo" looking spine. May also check sed rate and crp as inflamatory markers. If indeed this in AS, spinal extension exercise, walking and NSAID are indicated.

Scoliosis (a lateral curvature of the spine) could cause back pain. Depends on the severity of the curve. Hitting one's tailbone hurts initially but shouldn't cause this amount of pain in the back.

Kidney problems can potentially cause low back pain but probably are not connected with a high complement count unless something else (inflammatory) is going on.

All the best to you. Keep us posted.
 alexussl - Thu Jan 22, 2009 8:27 pm

thanks for the reply,
since my last post, I have been back to my family doctor. In the last month or so, I have been very fatigued, weak, and have been experiencing strange pains all over. they seem to be almost like an electrical pulsating feeling that flutters around lasting 30secs to a minute at a time. most are in the back, and chest, but do hit legs, toes, arms, and head. Increased numbness in hands and feet, and always feel cold or hot, never comfortable. Yesterday, I finally felt good, then today after work, the pains came back. the pains aren't intolerable, because it isn't persistent. the fatigue has me feeling almost flu-ish, and have a hard time with daily functions. I went for some more blood work, with all Rheumatic factors, and waiting for results. Protein is still elevated, been almost a full year now, and she feels it isn't connected to the back pains (still there), and now these new pains. Dr. seems to think it might be fibromyalgia, but needs to rule out MS, and other conditions.
You mentioned Systemic Lupus, sounds pretty likely, but no rash on my face, actually my face is the clearest it's ever been.lol . Would Lupus show up on routine blood work, or with the Rheumatic markers?
I am waiting to see a Rheumatologist, could be a few months.
Thanks again for your help. I'll post results once they are in.

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