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What Causes Fever, Night Sweats And Joints Pain?
Question: I have been running a low grade fever (99.6 - 100.7) for several months. I have periodic episodes of overall weakness, constant pain in several joints, and fatigue. I also have night sweats. All of my blood work and urinalysis came back normal, except my thyroid, which has been low for over 20 years has suddenly become overactive. I've seen a rheumatologist who told me I have fibromyalgia. My internist has thrown up her hands. Any suggestions?
Brief Answer:
Is it Fibromyalgia(?)
Detailed Answer:
Good evening,
Thank you for writing on HealthcareMagic,
Well, to conclude a diagnosis of Fibromyalgia, it is essential we rule out all other causes.. Since your blood work came negative they have made the diagnosis... I would like to ask you a few more queries before guiding you further
1. any history of weight loss or appetite loss?
2. any history of dry eyes or dry mouth?
3. any recent irritability or forgetfulness which has increased?
4. Were your ANA levels checked?
Lyrica is not the best drug if it was Fibromyalgia.. we may need to change it
But, please do let me know these queries at first, would guide you further from here
Regards
Dr Naval
Is it Fibromyalgia(?)
Detailed Answer:
Good evening,
Thank you for writing on HealthcareMagic,
Well, to conclude a diagnosis of Fibromyalgia, it is essential we rule out all other causes.. Since your blood work came negative they have made the diagnosis... I would like to ask you a few more queries before guiding you further
1. any history of weight loss or appetite loss?
2. any history of dry eyes or dry mouth?
3. any recent irritability or forgetfulness which has increased?
4. Were your ANA levels checked?
Lyrica is not the best drug if it was Fibromyalgia.. we may need to change it
But, please do let me know these queries at first, would guide you further from here
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Yes; I have lost 20 pounds since the first of March. I have no appetite and am forcing myself to eat.
No dry eyes or mouth.
Yes; I have been extremely irritable and seem to be more forgetful of late.
I think my ANA level was checked.
I am not presently on Lyrica.
I don't believe fibromyalgia is the correct diagnosis. My symptoms don't fit other than the joint pain. The joint pain varies in severity, but it is sometimes painful to walk (pain in hips, low back, knees and feet.) I also have pretty bad pain in my shoulders and hands.
No dry eyes or mouth.
Yes; I have been extremely irritable and seem to be more forgetful of late.
I think my ANA level was checked.
I am not presently on Lyrica.
I don't believe fibromyalgia is the correct diagnosis. My symptoms don't fit other than the joint pain. The joint pain varies in severity, but it is sometimes painful to walk (pain in hips, low back, knees and feet.) I also have pretty bad pain in my shoulders and hands.
Brief Answer:
Diagnostic dilemma
Detailed Answer:
good evening
Sorry for the late reply... had a long duty today
Well I understand it S hard to reach the direct diagnosis especially if the labs are normal and one can conclude to anything...
What we can do is, get an ultrasound of your joints which are painful. If they do show inflammation we know we are dealing with inflammatory arthritis or else it may be Fibromyalgia.
Cause till you are not convinced about it, there is no point of treatment as the most important component in treatment is for patient to be convinced they have the disease.
I still would want to rule out Sjogrens syndrome as that is the closest mimic to Fibromyalgia
do let me know for more queries
Regards
Dr naval
Diagnostic dilemma
Detailed Answer:
good evening
Sorry for the late reply... had a long duty today
Well I understand it S hard to reach the direct diagnosis especially if the labs are normal and one can conclude to anything...
What we can do is, get an ultrasound of your joints which are painful. If they do show inflammation we know we are dealing with inflammatory arthritis or else it may be Fibromyalgia.
Cause till you are not convinced about it, there is no point of treatment as the most important component in treatment is for patient to be convinced they have the disease.
I still would want to rule out Sjogrens syndrome as that is the closest mimic to Fibromyalgia
do let me know for more queries
Regards
Dr naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Could I have Sjogren's syndrome with negative bloodwork? How about any other autoimmune diseases?
Can you recommend what type of specialist I could see for help? I am really at my wit's end. I am so tired, in pain and feeling so weak I can barely function . . .
I've asked for a referral to see a rheumatologist. Any suggestions for tests I should request?
I have a referral to a rheumatologist. Can you suggest any tests or possible diagnoses I could suggest to the doctor?
Can you recommend what type of specialist I could see for help? I am really at my wit's end. I am so tired, in pain and feeling so weak I can barely function . . .
I've asked for a referral to see a rheumatologist. Any suggestions for tests I should request?
I have a referral to a rheumatologist. Can you suggest any tests or possible diagnoses I could suggest to the doctor?
Brief Answer:
Further tests
Detailed Answer:
good morning
Well yes you do need a follow up with rheumatologist only as only they can help you reach the diagnosis
Sjogrens syndrome is an autoimmune disease only which can cause generalized myalgias, fatigue, joint aches and lot of other symptoms which you are experiencing...You can discuss with your rheumatologist about this possibility as it is the most underdiagnosed condition.. . for diagnosis ANA and ENA profile need to be done and if they are negative we plan for a lip gland biopsy.. But since you have kuch of dry mouth or eyes symptoms it may not be specific..
Secondly just make sure your muscle enzymes have been done.. CPK LDH and aldolase
Thirdly, If we really want to pick up inflammation going on somewhere either we do a musculoskeltal ultrasound or a bone scan... This will help to pick up an inflammation going on anywhere in the body. If you can get a bone scan scheduled it will be helpful as it will cover your entire body.. So that should give us a fair clue on what we are dealing with or not
Hope the information was useful
When is your scheduled appointment??
Do let me know for more queries
Regards
Dr naval
Further tests
Detailed Answer:
good morning
Well yes you do need a follow up with rheumatologist only as only they can help you reach the diagnosis
Sjogrens syndrome is an autoimmune disease only which can cause generalized myalgias, fatigue, joint aches and lot of other symptoms which you are experiencing...You can discuss with your rheumatologist about this possibility as it is the most underdiagnosed condition.. . for diagnosis ANA and ENA profile need to be done and if they are negative we plan for a lip gland biopsy.. But since you have kuch of dry mouth or eyes symptoms it may not be specific..
Secondly just make sure your muscle enzymes have been done.. CPK LDH and aldolase
Thirdly, If we really want to pick up inflammation going on somewhere either we do a musculoskeltal ultrasound or a bone scan... This will help to pick up an inflammation going on anywhere in the body. If you can get a bone scan scheduled it will be helpful as it will cover your entire body.. So that should give us a fair clue on what we are dealing with or not
Hope the information was useful
When is your scheduled appointment??
Do let me know for more queries
Regards
Dr naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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