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DrKnowsBest, Doctor
Category: Medical
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Experience:  Family Physician with extra cert in peds and womens health
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extreme jaw pain, swelling of the face (swelling moved..joint

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I have just finished a period of illness which I believe may have been an exacerbation of SLE. My symptoms were extreme jaw pain, swelling of the face (swelling moved from left to right), extreme fatigue (unable to work for a week), nausea, headaches, decreased appetite and weight loss. I have a history of mild depression, sleep disorder, random joint pain, nose bleeds, sores in my mouth, frequent headaches, and memory loss. I saw 2 ER physicians (who had no ideas), an ENT resident and ENT attending (who ruled out anything ENT related), and dentist and an oral surgeon (who ruled out dental), and my family physician. I have had routine bloodwork done which ruled out any infection, and had a normal head and neck ct with contrast which came back normal. Does any of this sound like lupus to you?

DrKnowsBest : You need to have more detailed labs

Do the symptoms sound like lupus to you?

DrKnowsBest : Did they do am Ana sed rate or crp also an autoimmune vasculitis called takayusos can cause neck/jaw pain
DrKnowsBest : I would get a second opinion with a rheumatologist and they will confirm or rule out both
DrKnowsBest : R u there

i think they just did routine bloodwork. no one seemed too interested in investigating it after my airway was cleared



DrKnowsBest : Yeah er doesn't typically do this

the ent i saw said lupus never has anything to do with the jaw, which i found odd

DrKnowsBest : I have a patient wh turned out to have this and presented very similarly to you

its very strange because initially was diagnosed with an infection and felt better after the antiboitics


but then everything just came back so much worse. why would the penicillian even have helped?

DrKnowsBest : This could have been a secondary infection though as your immune system is suppressed with an autoimmune problem of any type

ok. what specific bloodwork should i ask my doctor to run?

DrKnowsBest : aNA, sed rate, crp, ccp, anca, lupus anticoagulant, rheumatoid factor

ok. i will ask her. but what if this all comes back normal? what is wrong with me?

DrKnowsBest : Could be viral or neurologic like neuritis with normal labs

how would they confirm one of those diagnoses?

DrKnowsBest : Trigeminal neuralgia can cause this pain pattern and swelling and would have normal labs I would see a rheumatologist either way

are there any tests for trigeminal neruralgia?

DrKnowsBest : It is a difficult diagnosis but if the labs are negative and the pain pattern fits it is diagnosed by a neurologist
DrKnowsBest : I think it is ore likely rheum though so start there

ok. i will go see my doctor and get her to draw the labs. from there i will see a rheumatologist or neurologist.

DrKnowsBest : Sounds good this will rule out all the above, if you a
DrKnowsBest : U are in a area with ticks have them check Lyme and Babesiosis

ok, i will talk to her about that too. thank you!

DrKnowsBest : Sure please press accept if happy with answer
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