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I have just finished a period of illness which I believe may

have been an exacerbation of...
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?
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Answered in 3 minutes by:
10/13/2011
DrKnowsBest
DrKnowsBest, Doctor
Category: Medical
Satisfied Customers: 1,496
Experience: Family Physician with extra cert in peds and womens health
Verified
DrKnowsBest : You need to have more detailed labs
Customer:

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
Customer:

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

Customer:

yes

DrKnowsBest : Yeah er doesn't typically do this
Customer:

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
Customer:

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

Customer:

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
Customer:

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

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

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
Customer:

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
Customer:

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
Customer:

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
Customer:

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

DrKnowsBest : Sure please press accept if happy with answer
DrKnowsBest
DrKnowsBest, Doctor
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Experience: Family Physician with extra cert in peds and womens health
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