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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Immunosupressed for still s disease. Night chills, fever, fatigue with swollen, painful ankle, red spots in the area. Help

I am immunosupressed (taking kineret 200 mg, methotrexate 30 mg., prednisone 20 mg. for adult onset still s disease. Recently I had very bad night of chills, fever, fatigue, pain--like a bad still s flare only it lasted all night. Like I was getting an infection. 48 hours later, my right ankle is swollen and very painful, calf swollen and warm and painful, and I have a few red spots around the calf. Not raised spots. Not vascular looking either. Saw doc today who isn t sure what it is but gave me doxycycline. I had a similar incident in May only with left knee. Doesn t look like cellulitis or a DVT.
Sat, 23 Nov 2013
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General & Family Physician 's  Response
hello there!
Thank you for asking.

To be on the safer road Check your platelets count . As these red spots non tender and sudden onset may explain them. its low platelets. Methrotrexate and other bone marrow killers you are using explain it.See the hematologist And do Platelet count, CBC, PT APTT INR to rule out bleeding diatrhesis. if that is ruled out too then all you would need would be a dermatologist to Rule out drug induced reactions like steven johnsons or some rashes.
Immuno suppression has its pros and conses. The sign and symptoms you mentioned clearly narrate some hypersensitivity to the medicine you are taking. Drug induced Rashes are not some thing uncommon. You need to see the dermatologist as all DVT or Cellutitis like troubling conditions have been ruled out.

Hope i was of some help

Take Care
Dr S Khan
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