HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Left Side Headache, Fatigue, Insomnia And Night Sweats?

default
Posted on Tue, 3 Feb 2015
Question: My internist thinks I may have lupus but is unsure. I can't see a rheum doc for another month.
Symptoms are excruciating left side headache they is constant but feels like a hammer when I lay down or stand up, extreme fatigue but insomnia, drenching night sweats, low grade fever, vasculitis on entire body, hot showers feel like like pin pricks, raynaud like phenomena hands, feet, and nose, chest pain and tightness, extreme sensitivity to alcohol, mouth ulcers and nose ulcers, liver lesions, abnormal ekg, intermittent high bp, resting heart rate 100bpm, retinal hemmorhage, intermittent eye ptosis, blurred vision, ringing in ears, feeling of fainting when standing, hip pain that switches sides everyday and radiates to my calf, extremely chapped lips, malar rash that comes and goes, hair loss, dermatitis in back, small red bumps all over legs, swollen face and hands every morning, urinating only twice a day no matter how much I drink, foamy urine that I have to force out, pain in elbows and shoulders, depression, memory loss, loss of appetite, weight loss. I have had a positive Ana in the past but it is now negative. Ct of the head without contrast showed nothing, ct of the chest with contrast only showed liver lesions, hep tests negative, Lyme test negative, his test negative, all stds negative. First blood work that came back showed low rbc and wbc but now are back to normal, high iron serum, had low platelets and now back to normal, small amount of sjogren antibodies but doc said negative, high normal for RA latex turbid, creatinine was high is now low normal, hematocrit low normal, mch high normal, mch high normal, rdw low, neutrophils low normal, sodium high normal, calcium high normal, protein low, trace bilirubin, alkaline phosphotase low, ast sgot 12, alt sgpt 9, iron saturation high normal, INR high, cancer antigen 15-3 12, tsh .5, vitamin d 25 hydroxy very low, anti dna ds ab qn 1. My current internist will do whatever tests I think I need but he has no idea with my symptoms and labs. Please help!
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Lupus It Is

Detailed Answer:
Thank you for asking

i read your question and i understand your concern. Your history fits the the ACR (American college of rheumatology ) criteria and more than 4 symptoms of your this multiorgan manifestation is pointing towards lupus.

Your labs are pointing towards lupus the anti double stranded DNA antibodies and ANA are both in favour of Lupus. I cant see anti XXXXXXX antibodies though, they should have been done too. Also your sjogren antibodies are pointing towards lupus as lupus give higher levels of normal sjogren antibodies. Also anti histones, anti SSA, Anti SSB, Anti cardiolipin , anti ribosomal P antibodies and anti RNP antibodies are advised.

You have been just on prednisone and that too very small dosage of 20 mg when it should be up to 60 mg at least in a day. Along with these other anti lupus agents should be administered like
Biologic DMARDs (disease-modifying antirheumatic drugs): Belimumab, rituximab, IV immune globulin
Nonbiologic DMARDS: Cyclophosphamide, methotrexate, azathioprine, mycophenolate, cyclosporine
Nonsteroidal anti-inflammatory drugs (NSAIDS; eg, ibuprofen, naproxen, diclofenac)
Corticosteroids (eg, methylprednisolone, prednisone)
Antimalarials (eg, hydroxychloroquine)

I am sure you will respond to the medications and lupus will be managed. After that you will just need maintenance therapy with hydroxychloroquine.

I hope it helps. take good care of yourself and don't forget to close the discussion please.

Regards
Khan
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
doctor
Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Left Side Headache, Fatigue, Insomnia And Night Sweats?

Brief Answer: Lupus It Is Detailed Answer: Thank you for asking i read your question and i understand your concern. Your history fits the the ACR (American college of rheumatology ) criteria and more than 4 symptoms of your this multiorgan manifestation is pointing towards lupus. Your labs are pointing towards lupus the anti double stranded DNA antibodies and ANA are both in favour of Lupus. I cant see anti XXXXXXX antibodies though, they should have been done too. Also your sjogren antibodies are pointing towards lupus as lupus give higher levels of normal sjogren antibodies. Also anti histones, anti SSA, Anti SSB, Anti cardiolipin , anti ribosomal P antibodies and anti RNP antibodies are advised. You have been just on prednisone and that too very small dosage of 20 mg when it should be up to 60 mg at least in a day. Along with these other anti lupus agents should be administered like Biologic DMARDs (disease-modifying antirheumatic drugs): Belimumab, rituximab, IV immune globulin Nonbiologic DMARDS: Cyclophosphamide, methotrexate, azathioprine, mycophenolate, cyclosporine Nonsteroidal anti-inflammatory drugs (NSAIDS; eg, ibuprofen, naproxen, diclofenac) Corticosteroids (eg, methylprednisolone, prednisone) Antimalarials (eg, hydroxychloroquine) I am sure you will respond to the medications and lupus will be managed. After that you will just need maintenance therapy with hydroxychloroquine. I hope it helps. take good care of yourself and don't forget to close the discussion please. Regards Khan