Discussions By Condition: I cannot get a diagnosis.

aches, pain, spots on arms, hair loss, anaemia - HELP pls!!!

Posted In: I cannot get a diagnosis. 7 Replies
  • Posted By: tanja145
  • June 2, 2009
  • 00:16 PM

22 yr old secretary returned from holiday feeling unwell, with widespread aches and pains.
excess hair loss and some spots on arms.
on examination: temperature of 37.5 degree Celcius, inflamed finger flexor tendon, small reddish lesions on both elbows and small patch of alopecia.

Lab results:
low Hb
low WBC (with neutrophils 70% and lymphocytes 5%)
ESR very high

Diagnosis: I was thinking SLE, anyone agree? PLEASE HELP got a test soon!
thanks to all!

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7 Replies:

  • In which country did you take your holiday?It could be relevant.
    chrismia 159 Replies Flag this Response
  • My first thought upon reading your post was SLE as well. But, more testing need to be done. See a rheumatologist. If your vacation was in a sunny place, the sunlight could have triggered a flare.
    Harmonium 322 Replies Flag this Response
  • The vacation either is or not relevant... this is an exam question, so if the name of the place was not mentioned, maybe it's not so relevant. thanks to all who responded, if you have anything more to add, I would be grateful if you add it!Thanks again...
    tanja145 5 Replies Flag this Response
  • If the were animals around, or if you came into contact with animals - especially wild animals such as in Africa, then a tick bite could be the culprit.
    NeverGiveUpBoy 26 Replies Flag this Response
  • thanks!!! :)
    tanja145 5 Replies Flag this Response
  • Well... it sound like SLE. A rheumatologist will check for ANA (not specific), for anti DNAds, anti Sm, anti Ro, anti La and anti nucleosom antibodies. If any of them is positive then considering your symptoms and the result of your your blood tests (low white blood cells, elevated ESR, proteinuria, anaemia probably secondary to chronic inflammation) there is a very very very high probability that u have SLE. If this is the case u should get checked for the presence or absence of antifosfolipid antibodies (lupus anticoagulant, anticardiolipin and anti beta2 GPI) especially if u ever had spontaneous abortions, frequent migrains, or any blood vessel clotted or u have livedo reticularis on your skin. In order to prevent flares of this disease u should always wear sunscreen with high SPF(even while going to work ), u should not use pills containing estrogens, and if u have associated sicca syndrome u should use artificial tears. Your doctor will give u medicines that u will take for long periods of time in order to make the disease backup, and u will need to get tested periodically. This diagnostic should not scare u because today with this diagnostic u can lead a life as normal as u expected it to be. When u will want to have a child you will need to check it with your doctor first and u will need medication and careful monitoring during pregnancy).You should exclude infections with Borellia, Brucella etc
    Lauritka 7 Replies Flag this Response
  • Thanks a lot for your detailed explanation!!! Much appreciated :)
    tanja145 5 Replies Flag this Response
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