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My question is besides the symptions mentions, I have extremely

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Posted on Thu, 28 Mar 2019
Question: My question is besides the symptions mentions, I have extremely hands and feet. I feel like my muscles feel stiff. Minor thing is constant itching and coughing . It’s been over 10 years I have also been dropping things randomly. Facial rashes and flushing

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Answered by Dr. Dariush Saghafi (56 minutes later)
Brief Answer:
I believe you may have an INFLAMMATORY CONDITION

Detailed Answer:
Good evening and I am very sorry these symptoms have been following you for the past 10 years. However, I believe you should see either a neurologist or a RHEUMATOLOGIST with a specialty in collagen vascular diseases.

Your description of symptoms and the time course as well as the MULTIPLE SYMPTOMS you describe suggest something of an inflammatory nature that may be or may be similar to an autoimmune process such as SYSTEMIC LUPUS ERYTHEMATOSUS (SLE). I say this because your description of problems (cold I suspect?? You forgot to type the exact descriptor) involving the hands and feet as well as "facial rashes" such as may be seen over the cheek areas of the face, coughing, and itching as well as the stiffness in the muscles are virtually textbook type symptoms of this disorder. Another possible mimicker of SLE could be SARCOIDOSIS so this should be kept in the differential. The big clue though to SLE (for me at least) comes down to the FACIAL RASHES and flushing which is consistent with the description of the MALAR OR BUTTERFLY RASH that mainly affects the cheeks both sides. Dropping things from the hands points to not only neuropathy (making it hard to feel things) but also weakness in the limb muscles.

If you call your nearest Academic Medical Center (i.e UNIVERSITY AFFILIATED HOSPITAL) then, I am very sure you would find someone extremely knowledgeable and competent in working up someone with your symptoms and applying the rubric of SLE or even a mixed connective tissue disease (although I believe the chance of this being SLE is extremely high).

Locate a good academic rheumatologist or a good NEUROIMMUNOLOGIST at an academic hospital and they will definitely know the best way to work you up and offer relief. We have so much more these days to successfully treat something like LUPUS that I'm sure at least 1 of the available treatment regimens would improve your overall quality of life.

I would make sure that all laboratory parameters looking for inflammatory markers and evidence of some type of vasculitic or collagen vascular disease were drawn and then, look to start some form of ANTI-INFLAMMATORY REGIMEN with some aggressiveness since you may be in the middle of a cycle.

And so, if I've provided useful or helpful information to your question could you do me the utmost of favors in not forgetting to CLOSE THE QUERY along with a few POSITIVE words of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few weeks if you'd drop me a line at: www.bit.ly/drdariushsaghafi

You can always reach me at that address for this or other questions. I wish you the best with everything and hope this information does help you.

This query required 22 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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My question is besides the symptions mentions, I have extremely

Brief Answer: I believe you may have an INFLAMMATORY CONDITION Detailed Answer: Good evening and I am very sorry these symptoms have been following you for the past 10 years. However, I believe you should see either a neurologist or a RHEUMATOLOGIST with a specialty in collagen vascular diseases. Your description of symptoms and the time course as well as the MULTIPLE SYMPTOMS you describe suggest something of an inflammatory nature that may be or may be similar to an autoimmune process such as SYSTEMIC LUPUS ERYTHEMATOSUS (SLE). I say this because your description of problems (cold I suspect?? You forgot to type the exact descriptor) involving the hands and feet as well as "facial rashes" such as may be seen over the cheek areas of the face, coughing, and itching as well as the stiffness in the muscles are virtually textbook type symptoms of this disorder. Another possible mimicker of SLE could be SARCOIDOSIS so this should be kept in the differential. The big clue though to SLE (for me at least) comes down to the FACIAL RASHES and flushing which is consistent with the description of the MALAR OR BUTTERFLY RASH that mainly affects the cheeks both sides. Dropping things from the hands points to not only neuropathy (making it hard to feel things) but also weakness in the limb muscles. If you call your nearest Academic Medical Center (i.e UNIVERSITY AFFILIATED HOSPITAL) then, I am very sure you would find someone extremely knowledgeable and competent in working up someone with your symptoms and applying the rubric of SLE or even a mixed connective tissue disease (although I believe the chance of this being SLE is extremely high). Locate a good academic rheumatologist or a good NEUROIMMUNOLOGIST at an academic hospital and they will definitely know the best way to work you up and offer relief. We have so much more these days to successfully treat something like LUPUS that I'm sure at least 1 of the available treatment regimens would improve your overall quality of life. I would make sure that all laboratory parameters looking for inflammatory markers and evidence of some type of vasculitic or collagen vascular disease were drawn and then, look to start some form of ANTI-INFLAMMATORY REGIMEN with some aggressiveness since you may be in the middle of a cycle. And so, if I've provided useful or helpful information to your question could you do me the utmost of favors in not forgetting to CLOSE THE QUERY along with a few POSITIVE words of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few weeks if you'd drop me a line at: www.bit.ly/drdariushsaghafi You can always reach me at that address for this or other questions. I wish you the best with everything and hope this information does help you. This query required 22 minutes of professional time to research, assimilate, and respond in complete form.