Question: Hi there, I was wondering if you could give me your clinical opinion on a diagnosis. Here is my current symptoms and background:

Current/recurring symptoms:

- Swelling in wrists and ankles - happens to both joints at the same time but worse in left. Stiff in mornings. Compression gloves help with swelling, if not used they can balloon.
- Pain and heat in knees.
- Ulnar pain can be extreme - worse in left.
- Redness across the face and nose when experiencing other symptoms.
- Nose goes bright red with any sun exposure.
- Frequent rashes - circular marks on upper legs, they occasionally present like a purpura rash (dots)
- TMJ.
- Reynauds.
- Seizure like episodes over the years - confusion/black outs.
- Frequent dystonia.
- Tremor - worse when tired.
- Fatigue - can be extreme and debilitating.
- Hip pain - both but more frequently the right.
- Blood blisters in mouth, angular cheilitis occasionally.
- Flu like symptoms - temperature all over the place and occasional night sweats.

History:

- Had a few positive ANA tests with speckled patterns. Also had a few negative tests when not experiencing inflammatory symptoms.
- Had a 12 month long episode of treatment resistant TTP (2008) - Pos ANA during admission. Surgical removal of large (grapefruit sized) ovarian benign tumour during treatment. Daily plasmapheresis not effective until high dose steroids were added.
- Had TIA (2011) which resulted in chronic neuropathic pain and a diagnosis of fibromyalgia.
- Fibromyalgia pharmaceuticals were ineffective - made the decision to swap to medical cannabis combined with other anti inflammatory herbs and supplements.
- Fibromyalgia symptoms still present but better controlled with cannabis. None-typical fibromyalgia (more inflammatory) symptoms have escalated and progressed over the years.

Thank you, I was considering the same. I'm resistant to immune suppressants. Would a biologic agent have less side effects?
Thanks for your time