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Suggest Treatment For Stiffness And Pain In The Joints And Butterfly Rash On The Face
Question: Hi,
I am a 47 female with a history of Hashimoto's autoimmune thyroid disease. In the last year plus I also developed a painful swelling under my left jaw on my neck. This has had an ultrasound/ct and MRI and nobody can tell me what it is. The pain comes and goes around the area but the swelling is always there. It's hard to touch, almost like an actual change in bone structure or something. My neck looks lopsided as a result. I went to an ENT who was baffled by this and has now referred me to a rheumatologist who I will see Friday. In the last two weeks I developed a high fever, a butterfly rash on my cheeks (which was so so sore like sunburn, I couldn't put anything on it it was incredibly sensitive) and fatigue and joint pain like I have never experienced in my life. I could hardly get out of bed and I'm a paramedic, very active and fit. I had onset stiffness on wakening too plus excessive pain in joints especially hips, radiating down thighs (feels like it's in my bones), onto knees, ankles, toes, and also elbows, shoulder fingers, wrists. Just everywhere really. This all lasted for about 4 solid days and today the rash has subsided, joints are a little less sore but still there. Bloods indicate high inflammation factor, negative ANA (although it was positive 3 months ago?), high ESR, and a few other blood things. Still more tests to come back. My question, sorry for the essay....I think I have SLE. Can I have this and still have a negative ANA? Thank you for your help!
I am a 47 female with a history of Hashimoto's autoimmune thyroid disease. In the last year plus I also developed a painful swelling under my left jaw on my neck. This has had an ultrasound/ct and MRI and nobody can tell me what it is. The pain comes and goes around the area but the swelling is always there. It's hard to touch, almost like an actual change in bone structure or something. My neck looks lopsided as a result. I went to an ENT who was baffled by this and has now referred me to a rheumatologist who I will see Friday. In the last two weeks I developed a high fever, a butterfly rash on my cheeks (which was so so sore like sunburn, I couldn't put anything on it it was incredibly sensitive) and fatigue and joint pain like I have never experienced in my life. I could hardly get out of bed and I'm a paramedic, very active and fit. I had onset stiffness on wakening too plus excessive pain in joints especially hips, radiating down thighs (feels like it's in my bones), onto knees, ankles, toes, and also elbows, shoulder fingers, wrists. Just everywhere really. This all lasted for about 4 solid days and today the rash has subsided, joints are a little less sore but still there. Bloods indicate high inflammation factor, negative ANA (although it was positive 3 months ago?), high ESR, and a few other blood things. Still more tests to come back. My question, sorry for the essay....I think I have SLE. Can I have this and still have a negative ANA? Thank you for your help!
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
First make sure your thyroid is well regulated. Tests will indicate the status of your thyroid.
SLE is possible with negative ANA but you will need to see a Rheumatologist for an accurate diagnosis.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
First make sure your thyroid is well regulated. Tests will indicate the status of your thyroid.
SLE is possible with negative ANA but you will need to see a Rheumatologist for an accurate diagnosis.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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