Brief Answer:
Calcium,
Magnesium, Vitamin Bc, kidney function, g
Detailed Answer:
Hi and thanks for the insightful update.
A past history of
gout could explain why she could have some nodules at the level of the hands/fingers. Nodules are a common manifestation in patients with gout.
Considering the fact that this has been going on for some time, it is imperative that her electrolyte profile (blood levels of especially Calcium and Magnesium). The drugs used in her case do have the potential of altering the blood levels of these electrolytes. It might also be very important to know when she last did a control for kidney function. Gout could be complicated by
chronic kidney disease. Under these conditions, it could have
neurologic manifestations as such, first due to generally low Calcium and /or Magnesium levels, and secondly due to the direct toxic effects of some the chemicals that do accumulate in the body due to inappropriate kidney function.
I would still think, in addition to screen for blood Calcium and magnesium, measure also Vitamin D levels (important for Calcium re-absorption) and Vitamin B complex
Vitamins. Control kidney function in case this has not been done lately. As mentioned earlier, nodules could be explained by the fact that she has gout. Tightening gout control through the drugs (
Allopurinol) and diet recommendations (much fluids, less Alcohol, low animal
proteins especially red meat) could be very useful.
Kind regards and hope this helps. Do feel very free asking follow up questions in case of need. Wishing the best of health.
Dr Bain