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Causes for diarrhea,bloating,appetite loss,abdominal pain and cold felling in extremeties?

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Practicing since : 1999
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Hi! I am a 58 year old female, who began experiencing flu-like symptoms-diarrhea, bloating, lack of appetite, pain in upper middle abodemal area-right below ribcage, fever alternating with feelings of extreme cold in extremeties, muscle spasms and increased pain in hands, knees, hips and feet. I have lost quite a bit of weight and the "episodes" have rapidly increased in frequency. I test positive for ana, and both my scl-70 and rnp antibodies are high. I live in the country and specialists are hard to come by. I have been waiting months now to see an endocrinologist and a rheumatologist. But I keep getting sicker. Could I have diffuse scleroderma and/ or SLE? If so, what further tests should I ask for? I am so ill, I have no quality of life left, so I am desperate to find out what is truly going on. I'm not techno-savy, so I'm not sure how to upload the various blood test results I have had this year. I can tell you, I have tested positive for ana, and my scl-70 and rnp antibodies were high on every blood test this past year (2013) where they were tested. Once, when I was especially ill, the blood work also showed I was anemic and that my platelets were low. Everything else looked OK, and the rnp and scl-70 antibodies, while high, were not grossly above the top number for normal.
Posted Thu, 23 Jan 2014 in Lupus
Answered by Dr. Alokkalyani 1 hour later
Brief Answer: systemic sclerosis/ SLEor MCTD Detailed Answer: Hi I am Dr Alok, it seems that you probably have mixed connective tissue disorder (MCTD). I would like to know few more clinical things-- 1. Do you have have skin problem - thickening and tightening of skin 2. Do you have problem in finger tip on exposure of cold - I mean to ask color change 3. Do you have history of hair fall or oral ulcer or skin rashes 4. Do you feel breathlessness on exertion? This is confirm with your investigation that you have connective tissue disorder - may be SLE or systemic sclerosis or MCTD, but with clinical history , I would be advised to better
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Follow-up: Causes for diarrhea,bloating,appetite loss,abdominal pain and cold felling in extremeties? 8 hours later
I am very fair, but I have a long history of keloiding with even minor cuts. I have unexplained keloids on my face and lumps on my scalp right nowg. I also have had fibroid tumors in my breasts for years. Since these episodes began, my fingers have become, and remain very swollen and cold. My fingers and toes turn purple when very cold and recently, my hands have started going into spasm--they pull up so sharply that my fingers look broken--pulled in different directions at the joints. I have a lot of joint pain, especially in my hands, and there is a history of rheumatoid arthritis in my family, but I have been told I just have normal arthritis. With these episodes, my nose and cheeks turn bright red. Sometimes, my forearms and thighs do also. During an episode, I sweat profusely, especially from my head, with no exertion. Then, I can turn so cold that multiple blankets and comforters can't get me warm. During an episode, my heart races and my chest constricts to where I feel I am gasping for air--but I have tachycardia and am on Metropol, so I don't know if this is related to the episodes or not. I neither drink, nor smoke, nor take illegal drugs--and never have. I have a history of hair loss--I have practically none on my body and the hair on my scalp is very fine and almost all gone on the top-but I do have low thyroid and am post-menopausal--however, the only sores I've ever had were recurrent herpes zoster on one place on my neck. I do, however, have a history of hives. One particularly bad event, a few years ago, went on for months, with large lumps under my skin everywhere. The doctors said I had developed an allergy to Amoxicillin. My skin itches during these episodes, but the only thickening I've seen is in my fingertips. As I said, my fingers are so tight, I'm constantly trying to pull them out from a claw-like position. Does that help?
Answered by Dr. Alokkalyani 2 hours later
Brief Answer: systemic sclerosis / MCTD Detailed Answer: Hi, so it seems that you have systemic sclerosis/MCTD, unfortunately this is a difficult disease. But can be treated well by a trained and competent Rheumatologist You should see your rheumatologist as soon as possible. Meanwhile you should protect yourself, especially fingers and toes from cold weather, cold water and injury. You should go for HRCT and PFT test for your lung and ECHO for your heart evaluation. Avoid high fat diet, and smoking Avoid lying down and sleep within 3 hour of your last meal Vaccination of pneumonia and flu is also important Physiotherapy can help you from preventing deformity. There are many medication available, which can be helpful, you can discuss with doctor. If Any further queries, please donot hesitate...
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