Re: rheumatologist for autoimmune work up? strange symptoms
Your symptoms could certainly fit with lupus, as lupus causes rashes, high blood pressure, especially if there is any kidney involvement, swollen lymph nodes and marked fatigue. It is common to have a negative test result for lupus, particularly early in the course. So there are a number of ways to check this out. One is that there are numerous other antibodies and inflammatory markers, etc that can be tested in the blood that may not be definitve, but can provide clues. The rash can be biopsied and immunofluorescent studies done, which will sometimes yield a diagnosis. Urine should be examined for blood, protein and casts, for possible lupus kidney involvement. A complete blood count, and chemistry panel should also be done to look for anemia, low white cells, low platelets, liver and kidney function. Lastly, one of the enlarged nodes could be biopsied. It is important also to repeat the ANA test periodically, as if it is lupus it most likely will eventually turn positive, although that can take months or even years in some people. If your rash is brought on by sun exposure, that is characteristic of a lupus rash. So the diagnostic process can take some time, and some Drs will go ahead and treat a person if the clinical suspicion is high, even without a definite diagnosis. I hope you get answers soon and feel better. The beta blockers for the high blood pressure may exaccerbate the fatigue, and it would be good to consider other medications or a combo of meds instead of just raising the dose repeatedly. I would discuss this with your Dr who is treating your high blood pressure. ACE inhibitors have a protective effect on the kidneys and are very effective for lowering BP. They can be used in combo with beta blockers, so the BB dose can be kept down. Glad you found the boards, and hope your workup goes smoothly. Please keep us posted on your progress.