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Thank you for writing in today. I want to provide you with the best possible information, so I do have a few questions. I hope you understand.
Can you tell me more about your clinical workups? Have you been seeing a neurologist, immunologist, hematologist, rheumatologist, etc? Have you ever had a muscle biopsy, nerve conduction studies, MRI, or CT scans? Do you know what type of lab tests you have had done?
Any other illnesses?
Any other medications or supplements not mentioned here?
How long have you had these symptoms?
How long have you been taking the prednisone and Imuran? Any improvement?
Any skin issues?
Please let me know.
Thank you for responding.
Obviously, I can't act as a substitute for medical care, due to the limits of the internet. However, I can offer some suggestions. First of all, I hope that you have had a B12 and folate level assessed. Sometimes deficiencies in these areas can cause some of the paresthesia like symptoms you describe. Also, you may want to consult with your rheumatologist and discuss a complete workup for Lupus. Many of the symptoms you describe are significant for possible Lupus. In addition, if you develop any more skin lesions or lesions on your itchy scalp, you may want to discuss having a biopsy or skin scraping done. Sometimes skin can provide some vital answers regarding autoimmune disorders. Also, I am hoping you have had some liver function test blood work. Sometimes liver problems can cause similar symptoms; however, since you are on Imuran, I suspect this was done and, if abnormal, would have been discussed. Finally, sometimes eosinophilic syndromes can cause similar symptoms; however, I am least concerned about this, since an eosinophilia would have likely been detected on a CBC and discussed with you.
I realize this isn't a definitive answer; however, I hope some of the information may be helpful. I encourage you to discuss this with your provider. If you have any additional questions or concerns, please let me know.
Generally a B12 and folate level will show up with this name; however, the B12 may also be referred to as Cyanocobalamin level. These are tests that are done to specifically assess for pernicious anemia type of paresthesia. Although, a pernicious anemia should be detectable in your CBC, due to changes in the red blood cells. It's always a good idea to check the B12 and folate level. Sometimes a B12 and B complex supplement may help; however, sometimes people require injectable B12. The intrinsic factor in the stomach helps with the absorption of these vitamins. With age, people are have less intrinsic factor and are less able to absorb B12 naturally. Hence the need for injections, rather than oral, in some cases. This is why B12 injections are so common in the elderly. Also, other conditions, such as alcoholism or chronic gastritis, that may reduce the absorption in the stomach can increase a persons risk. In your case, since you take Nexium, this puts you at increased risk, since this reduces your acid production.
I hope this helps. This is alot of information, so if you want me to clarify anything, please let me know.