Question: I am a 60 year old woman. I have chronic, recurring splinter hemorrhages under all of my fingernails. I have been seen by rheuma-. derma. and cardiologists. Blood work and cardiac tests do not indicate any disease. I have pretty severe osteoarthritis, mild psoriasis, hypothyroid, high bp (sometimes). I have a history of cataracts, endometriosis, gall bladder removal, carpal tunnel and trigger fingers. The accompanying fatigue and pain is what causes me to be concerned. But, I wonder if I have something systemic like vasculitis or lupus that has not appeared in the blood work. (I have had high and borderline high ANAs - but negative on the other antibodies.) I don't even know what kind of specialist to go to.

don't know what XXXXXXX APLA platelets are but last blood work that was out of range showed: CCP antibodies 1 (0-19 units range); TSH 5.950 (.450-4.5/ml) Complement C4 - 38 (9-36mg/dl); CRP 2.04; ANA titer 1:160 (It has been as had as 3.60). I had lung x-ray when I had bronchitis, but only indicated the bronchitis. Have had chronic cough that comes at spells but is ot terrible or bothersome (I"m a non-smoker.) My Mom had MAI lung disease. No kidney function tests (I have had a kidney stone and surgery to remove it - with history of UTIs prior to removal.) Mom also had hashimoto's thyroiditis, sjogren's, and rheumatoid arthritis. sister has RA as well - so I have a history of autoimmune diseases. Should I ask for an XXXXXXX or APLA? IF it is vasculitis - is it a primary or secondary to something else? (I have worked in hospice for 10 years and picked up on some medical language - otherwise, I'm dumb about these things. :) Thanks for your response.