Question: Im 37 year old male i have had a lot of kidney trouble that have came with these flair ups of other symptoms, ive been breathless, chest pain about an inch to the left of the chest bone that comes with a stabbing pain, testicular pain. Back in march this year started a new symptom, i noticed joint pain in my fingers and sometimes my toes but the joint pain got worse to my hands, wrists, elbows then about 3 weeks ago i then got pain in my ankles my kness and shoulders and i knew that this had something to do with this kidney pain that ive had on and off for two years now with not much relief from the kidneys flairing up that comes with a stabbing pain but mostly a dull ache all the time. Its the left i get more bother with but the right one does get the same symptoms too. I do suffer from headaches alot and have had dry eyes alot that can sting when rubbed. Mouth alcers from time to time to. A flakyness of skin behind the eyebrows. I am sensitive to sun light that my eyes are almost shut or i shut one of my eyes due to light. I have suffered from schizo-affective disorder for many years but i know think that it is an auto immune disorder instead for when i stopped seeing people who had a very negative impact on my emotions my symptoms that had affected my mind went away very quickly, i do not handly negative emotions very well i can get very moody. When i was 17 i had suffered a grand-mal seizure which the doctors at the hospital didn't understand why, when i was in hospital for a different reason a twisted bowel. I also had these weird skin markings on my torso which my parents thought it was ring worm but came back negative and the gp didnt know what it was. I still have this skin condition that leaves a different pigment on my torso where these skin markings used to be and they do come back at times. My dad is diagnosed with pernicious anemia and his mum died when she was 43 with scleroderma and got blood poisoning due to a blood transfusion. I forgot to mention that for almost 3 years i was symptom free of my schizo-affective disorder and got the all clear from my psychiatrist but last November i suffered a full blowing delusion due to being under alot of negative or emotional problems. I also have very foamy urine that seem darker in colour than usual. I have had diarrhoea with this at times to and vomiting aswell, but not had this since January. i was put on antibiotics for ten weeks to rule out an affection. So i definitely dont have affection. I am positively sure i am suffering an auto immune of some sort but do not no what. Could you please advise as this would be much appreciated. XXXX

Answer to Q1 yes early morning stiffness but no swelling. Q2 no rash when in sun. Q3 yes dry mouth and yes i do drink alot of water for it. Q4 No hair fall. Q5 Yes mouth ulcers painful but no genital ulcers. Q6 Yes my wife and i have noticed that i do suffer from forgetfulness or even trying to make sense of things that my mind seems to just shut down and i usually say to my wife "what was i saying" or even understand something, even my close friend has noticed this aswell. Yes i do get very irritable like almost a personality change i suffer angry alot with it with, because of how i feel i wonder who is the real me specially when my wife says this is not you. Q7. Yes just regular blood test ( normal) but i am waiting for my b12 results. Q8 No i dont think so.
Regarding my eyebrows theres no rash but they do flake alot like if you had bad dandruff but much bigger bits and noticeable to by others. My dad suffered this until he was treated with his pernicious anemia he said.
Another symptom i forgot to mention is i have suffered from fatigue trying to do the simplest of tasks felt impossible then when the fatigue came on and believe me when i tell you this, it feels like my energy levels are suddenly being drained from me, then i would start to suffer the other symptoms i have mentioned to you. Another symptom that i have had when i feel i am getting one of these flair ups, is when taking a deep breath in i get a really sharp pain in the chest and when this happens it makes me want to breathe a bit more shallow. I have suffered palpitations and pain in the calfs. Not sure if this is relevant but not long ago when i got my blood taken from my both arms i came up in a sudden rash on my arms from where the blood had been taken from, that my gp got a bit of a shock and asked me if this has ever happened before, i said no i have had blood taken before many atimes and that has never happened. From yesterday i was suffering from this fatigue feeing that i couldn't even go to work. Today i have joint pain in my wrists and my elbows very painful indead and feeling breathless too and my kidneys have been very painful today and i do feel i want to be left alone by my family as i feel that i will be irate with them.

I should of told you that 2 years ago my wife was breast feeding so we we're using condoms and i took a bad reaction from one and after ejaculation into the condom i got a terrible burning sensation up my urethra that i have never experienced before. The next time i had sex i had blood in my semem and this happened a number of times, the time a saw a urologist it had went away and he said if it comes back again i would need antibiotics. It did come back again but i didn't bother seeing my doctor because i thought it would just clear up again, which it did. 2 to 3 months later that is when i was getting my stabbing pain in my left kidney.

When i was getting pain in the kidneys which was a stabbing pain and over the next few months it got quite serious that i was vomiting also bad bouts of diarrhea, the worst nausea i have ever experienced. The most dreadful fishy foul urine, that even made my wife felt ill after i came out of the bathroom, the smell was that bad. I had to go into hospital, i was put on morphine and i could still feel the pain. I had a ct scan the following day to see if there was a kidney stone but nothing showed up on the ct scan. I left the hospital and days later i did pass a stone which looked liked a old arrow head made out of XXXXXXX which was 5mm in lenth and 3mm across. I was they diagnosed with renal colic by my GP as i had passed small bits of grit to that i caught in a fine metel sieve.

I do believe that was was producing these stones because of a bad bacteria infection that a caught using that condom. Anyway as time has moved on i felt i was not getting any relief from my kidneys and i thought that my doctors have missed something. I noticed another symptom that i was getting and it was coming from inside my bottom and the pain was really sore when sitting on a chair, and i also was rushing to the toilet about 5 times at night and also feeling the need to go but not much urine coming out. I decided to go A and E and i got diagnosed with prostatitis and put on antibiotics for 6 weeks. I then went back to my GP as i was still complaining about my kidneys and asked could i be carrying a bad bacteria infection and thats why i have these problems. I got a futher 4 weeks of antibiotics to rule out an infection. I started the antibiotics in April just after i was suffering joint pain in the beginning of march. I did complete the course but to no prevail as i am still suffering. I have had my blood results back and my b12 was 4.65 and my hemoglobin levels are 15.2 the last before that was 15.8 and the one before that blood test was 15.4. Got told they were normal. Like i said in my last notes to you my joint pain got alot worse, at the end of may that is when i was getting joint pain in my knees, ankles and shoulders and i knew it was going to get worse when i first felt that knew symptom back in march. I have had a dry cough aswell for some time now and i believe it is affecting my lungs because of the breathlessness that i get and the feeling someone is standing on my back. When these flair up start it does make me very fatigue and has also given me pain in my testicles and a stabbing pain in the chest when sometimes taking a deep breath in which makes me breath more shallow. I was at the dentist on Monday had have been diagnosed with gum disease. I feel my body is shutting down on me and i was in great health before the bad reaction to that condom. I do not drink alcohol or smoke, i am 5 foot 10 inches and have a waist of 32 inches.

My wife and i have noticed a slight redness over my nose and slightly on to my cheeks with a look of dryness too. Been married for 15 years and my wife doesn't recall that being there. I was on holiday in the sun at the end of May and its not sunburn and the skin does does feel dry to touch. Another point i would like to make is when i have joint pain say whether its the elbow or the knees or the wrists, its the exact same in the left elbow aswell as the right and so forth with the other joints. I suffer headaches alot my kidneys hurt mostly all the time but more in the left one than the right. I do know that what ever autoimmune diseases i have got it can affect my mind after that delusion i took back in November last year because i was under alot of emotional stress. You now know everything so any advice or if you think this is something else please tell me what to do. Thank you for your help. Kind regards XXXX

Hi Dr Naval I had only two of the tests mentioned the ana one and the rheumatoid factor both normal which was told by the GP receptionist but the ana test I don't think it was a IFA method, does that matter and is there a difference. Yes I have started to get a rash on my face when in the sun, my younger brother gets this to. I also want to point out to you that from the age of 14 I suffered migraines but grew out of them in my 20s. When I was a teenager I have suffered these disc shape rashes on my torso that are slightly raised and have a pigment discolouration to them and can disappear but appear in the hot weather. I live in Scotland so in winter it's always over cast and that is when the rashes seem to go away. Definitely think it's the sun that causes them to appear again. My mouth sores are not painful, my wife told me to right down that mouth sores are painful because I had forgotten what to say to you when you had asked about them. I only get them when I suffer stress but don't recall them being painful. My joint pain is mostly in my hand, wrists and elbows and can change suddenly from one side to the other very quickly. I have had joint pain in my knees and ankles and I couldn't put my foot down due to the pain and this was the worst I had suffered when on holiday. All my lymph nodes are swollen but I don't feel ill until I get one of these flair ups. Had a dry cough for a while now.

I am beginning to also think that I was wrongly diagnosed with schizoaffective disorder because I've been off medication for almost 4-5 years with no symptoms during that time until I had a delusion back in November and that was due to emotional stress. Now schizophrenia does not just disappear it is a life time illness and you need to be on medication, is there an auto-immune that can cause psychosis.

Thank you Dr Naval

Another question I would like to ask if this is lupus, because I have suffered having a kidney stone and prostatitis is that why I don't get relief from the pain of the kidneys and the prostate because the the disease is attacking those organs now? And yes I do get the pain after being in the sun, because I have been paying attention to my symptoms when I have been out in the sun, it does cause these flair ups. The longer I've been in the sun the more painful the symptoms are. When I stay inside my home for several days, I do start to feel better. I am not sure if I told you but these round disc shape rashes that I have had since I was 14 I know believe these are the lupus lesions, they don't itch, they do leave a pigmentation to my skin and now because of your help, I now realise why they start to look more aggressive is because of the sun. They are slightly raised on my skin too. Regarding my psychosis I have never been totally symptom free as I suffered a delusion back in November but I have helped myself by staying away from people who used to cause me emotional stress then I wouldn't suffer any paranoia. If you could answer these questions it would be much appreciated.

Hi Dr Naval

I wanted to send you a message earlier on today but was out and didn't have much battery left on my iPad. I am going private to see a rheumatologist. Today was a hot and clear day in Scotland with some clouds, I thought I would really test it out to see if the sun is causing my pain in the kidneys and my joints. I was in the sun for 20 minutes or less, this was about 3:30 pm. Three to four hours later, got the pain in both my kidneys and my elbow joints was very painful. I had to lie down cause of it. I find it hard to believe that the sun can do this. Scotland is mostly always overcast, is that way it's not that bad when I am outside but when it's hot and clear is that why I suffer these flair ups? It would explain a lot to my wife and I when I happen to be on holiday with hot weather, I end up being really ill. I realised in my last message I said about the prostate hurting, I didn't explain myself right, it's my testicals that end up hurting sometimes. I have noticed that I do get dizzy when getting up from a sitting position now. My wife thinks it's lupus because she did some research I found that my mum had a rash over the bridge of her nose and round the cheeks. My mums sister has lupus, I was told lately. Sent my urine to get tested and waiting for the results, but before I handed that sample in I tested my own urine on the test strips which are the same as my doctor use. The one that says PRO changed colour from yellow to the pale green which said on the pale green 15(0.15). Should this be a concern as it only happens sometimes?

I wanted to send my last message before you had replied yesterday. When I had been in the sun for 20 minutes and had the pain from both the kidneys and joint pain in my elbows, I can see it is the sun's heat that is making me unwell because of your last message. After getting up this morning i am feeling so fatigued, 3 hours has passed I feel no energy and very light headed and stiffness in the finger joints, this is the same feeling when I have been on holiday in the sun's heat accompanied by the joint pain and I don't think this is a coincidence after reading your message. (I'm the type that needs a lot of persuasion when it comes to strange things). Because I live in Scotland we don't really get good weather, it's mostly dull and grey and not very hot, but sometimes we can get good weather, like yesterday it was hot so that's why I went in the sun to test it out. When I was in XXXXXXX which is on the coast of England, they had very good weather. It was hot with clear blue sky and that was in XXXXXXX and that was one of the worst flare ups I had as it was the first time my knee joints and my ankles was extremely painful accompanied by feeling fatigued. I have noticed that the pain in my joints can quickly change from one side of the body to the other. Since speaking with you I am paying more attention to my symptoms and now I believe it is the heat that is causing my problems to get worse. I am seeing a rheumatologist on the 28th of July, I am quite nervous if I get diagnosed with lupus.

Also my elbow joints are really sore today and feel very light headed and fatigue.

Pain in my elbow joints were very sore today and also felt pain in my left knee and chest pain, I took some ibuprofen and it actually helped quite quickly with the pain after 30 minutes.