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What Causes Sweating,fatigue And Grey Colored Stool When Sufferimh From SLE?

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Posted on Thu, 4 Sep 2014
Question: I have SLE and primary biliary cirrhosis. I have been experiencing sweating, claminess , clay colored stools (sometimes diarrhea), extreme fatigue, weakness, loss of appetite and a disconnected feeling. Any ideas? Thank you. I'm 57 and have been under care for lupus since I was 29. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (1 hour later)
Brief Answer:
primary biliary cirrhosis active, needs treatment

Detailed Answer:
Good evening XXXXXXX The symptoms you are describing look more in the favour of primary biliary cirrohsis at the moment. It is also an autoimmune condition and has a strong association with other autoimmune disorders like SLE, Sjogrens syndrome and scleroderma. Unfortunately not much treatment is available for primary biliary cirrhosis. But I want to know:

What treatment you are taking for lupus as steroids can work in both the diseases
How are your blood reports like cbc, ESR, urine routine and kidney function tests, we should rule out any activity of lupus as well.
Do you experience any dry eyes or dry mouth.

Kindly let me know the answers to these questions , so I can provide you with a final solution
Hope the information was useful.
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naval Mendiratta (2 hours later)
I currently take 5 mg of prednisone per day and urso forte for the pbc. For lupus i also take plaquenil, tramadol, meloxicam, sertraline for associated depression, neurontin for nerve issues due to rods and pins put in my lower spine. Blood work was done in Feb. 2014 and looked okay. I always have blood in my urine and there also was small amount of protein, bilirubin, leuk esterase and wbc's. I have been through 3 rounds of antibiotics for these issues. I have not had a completely normal urine test. I am due next week for another check. Alkaline phosphatase was elevated. I did not have the ESR test done. If you have any other questions i will be glad to answer them the best I can. Hopefully these answers are helpful and what you were asking for. Thank you so much for your time and expertise. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (7 hours later)
Brief Answer:
? SLE Activity ? PBC activity

Detailed Answer:
Good evening XXXXXXX

I went through the results you have sent. The abnormal urine is somewhere an indication that the lupus activity is not fully controlled. I am not sure here. Probably your Rheumatologist would have seen the same urine report over a period of time and probably he would have decided not to increase the therapy. But you can discuss with him regarding the need for other immunosuppressive, like mycophenolate or cyclophosphamide. DO get your ESR checked as well, that will give us a clue whether SLE is active at present.

I understand Diarrhea is your major concern right now along with feeling fatigued, clamminess and loss of interest. All these symptoms can be a sign of either SLE activity or due to PBC.

What I will suggest is, lets get your blood tests done. We need to rule out any SLE activity. If that is present, we can increase the steroids and control it. But if it is due to PBC, the options get limited. We can try increasing the dose of Urodeoxycholic acid .

As for diarrhea, we should rule out any association of celiac disease. IT is a very common condition associated with SLE. You can get IgA anti endomysial antibodies and Tissue Transglutaminase antibody done. If those are negative and lab has not shown anything as you said, the next line would be colonoscopy, to investigate any intestinal problem. If that is clear, at least we are sure there is nothing serious there and we can treat it on the lines of Irritable bowel Syndrome.

Hope the information was useful. Do let me know if I can be of any more help.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naval Mendiratta (2 hours later)
Thank you so much. I will follow through with your suggestions.
doctor
Answered by Dr. Naval Mendiratta (22 minutes later)
Brief Answer:
my pleasure

Detailed Answer:
Oh no problem at all XXXXXXX I will feel good if I could be of some help. Feel free to contact me whenever you wish to. Take care..you can let me know your blood reports.
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. Vaishalee Punj
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Causes Sweating,fatigue And Grey Colored Stool When Sufferimh From SLE?

Brief Answer: primary biliary cirrhosis active, needs treatment Detailed Answer: Good evening XXXXXXX The symptoms you are describing look more in the favour of primary biliary cirrohsis at the moment. It is also an autoimmune condition and has a strong association with other autoimmune disorders like SLE, Sjogrens syndrome and scleroderma. Unfortunately not much treatment is available for primary biliary cirrhosis. But I want to know: What treatment you are taking for lupus as steroids can work in both the diseases How are your blood reports like cbc, ESR, urine routine and kidney function tests, we should rule out any activity of lupus as well. Do you experience any dry eyes or dry mouth. Kindly let me know the answers to these questions , so I can provide you with a final solution Hope the information was useful. Regards