Question: Respected Doctor,
I had mild bilateral shoulder joints pain, back pain, hip/knee joints pain for last more than 10 years. As per radiological reports - Mild osteoporasis, mild/early spondyliosis. Rheumatoid Factor was negative. Blood Urea, Uric acid were normal. Very casually I took some pain relieving medicines and calcium tablets under prescriptions of doctors but those never could do anything but I was tolerating and was doing some mild physical exercise. Recently in the middle of month of July last(almost 4 months back), I have developed whole body pain, restricted movement, swelling of face & limbs, mouth ulcer, throat pain/swallowing difficulty, itching skin almost whole body and later hardening/thickening/tightness of skin. Initially doctors gave some anti-histamin, vitamin, anti-inflammatory medicines and skin lotion/ointmment but those could not do anything. Condition became very serious gradually. Many pathological tests done more than once. Hb% was 10.5, Eosonophil was 23, 24,20. ESR 48 & 55. CPK 239. Absolute Eosonophilic Count was 369 and after one month 1660. TSH was 3.4 then 6.5 after one month and huge vitamin D deficiency. Doctors later suspected MCTD/Scleroderma but all auto-immune tests was negative more than once. Before this condition I had strenuous physical exertions with load of work for family problems for more than 6 months. After suffering for 2 months I was admitted in a Hospital. On the basis of clinical observations and as absolute eosonophils count was found very high and all auto-immune screen being negative repeatedly, a group of doctor diagnosed it as "Eosonophilic Faciities", I was given 1 Vitamin D Inj after 2 days, Pulse Methyle Prednisolon Inj 1g each for 5 days. Condition had improved immediately as I responded to the dose and tolerated it very well. Discharged with Oral Tablet Wysolon(Pednisolon) 40mg OD with other medicines and after one month added Azoran(Azathioprine) Tab 50mg ODas non-steroid immunosupressant. I was doing/feeling well gradually but after some days some body pain started. Now I am taking Wysolon 35 mg OD, Azoran 50mg OD, CCM 1000 OD, Esomeprazole 40mg BD, Thyronorms 50mcg, Calcitrol + D3 Satchet 1g once in a week. Gradually it became unbearable. Now I have bilateral shoulder joints pain/stiffness, back pain, hip/knee joints pain, restricted movement. Consulting doctors are in a dilemma now whether it is relapse of primary disease in new form or a new symptom or it is a side effect of steroid/immunosuppressant because they told that as the patient is in steriod, there should not be such pain. After treatment given Complete Blood Test and LFT were done 3 times after interval of one week and everything is normal till now. They gave some physiotherapy. Referred for Rheumatology opinion. Would you kindly advise me next course of action ?
Thanks & regards. XXXXXXXX, 11-12-2014