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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Symptoms Of Severe Fatigue, Lethargy, Affecting ADLs, Weight Gain, Fever, Had Fibromyalgia. Done MRI. Is It Lupus?

I have symptoms of severe fatigue/lethargy/affecting ADLs, weight gain with no diet or lifestyle changes, generalized pain/malaise, insomnia, fever of 99.5f to 101.5f x 1yr, and I feel worse than crap. I was dx w/ lupus-like syndrome 18yrs ago and Fibromyalgia 16yrs ago. I've always had a fatigue and pain, but my sypmtoms have been markedly worse for 1 yr.
I had a Cortrosyn Stimulation Test this AM and 25 mg/l was my baseline; it increased to 32 after 30 min; the increased to 37 at 60 min post injection. The high range for normal s 19mg/dl. I had a normal MRI of the Stella Turcica this AM as well. How would you interpret my findings? I've looked the interpretation up, but it's unfamiliar to me and I want to know more about it. I know it should elevate over time, but I'm not exact on what the baseline elevation indicates
Mon, 1 Jul 2013
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General & Family Physician,  's  Response
Hi and thanks for the query,

Interpretation of these results would require that many parameters be taken into consideration. First, you have already been on treatment, and steroid therapy, for that reason. This alters somehow the normal inflammatory response and distorts to an extent the expected physiological hormonal changes. Expertise of an endocrinololgist in the interpretation of these results is advised.

It is possible you could have a mixed connective tissue disease. Symptoms here span from those fron Sjogren's, syndrome, Lupus, mixed connective tissue disease. Your rheumatologist will certainly ask of an ascernal of biological tests (ANA, p ANCA, cANCA, CrP, ESR, CBC, Rheumatoid factor, Anti Ds DNA, anti Sm antibodies). X rays to evaluate any degenerative of demineralization lesions at the level of the joints could also be seen.

I strongly suggest you consult your rheumatologist and an endocrinologist. Thanks and kind regards,

Bain LE, MD.
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Have Symptoms Of Severe Fatigue, Lethargy, Affecting ADLs, Weight Gain, Fever, Had Fibromyalgia. Done MRI. Is It Lupus?

Hi and thanks for the query, Interpretation of these results would require that many parameters be taken into consideration. First, you have already been on treatment, and steroid therapy, for that reason. This alters somehow the normal inflammatory response and distorts to an extent the expected physiological hormonal changes. Expertise of an endocrinololgist in the interpretation of these results is advised. It is possible you could have a mixed connective tissue disease. Symptoms here span from those fron Sjogren s, syndrome, Lupus, mixed connective tissue disease. Your rheumatologist will certainly ask of an ascernal of biological tests (ANA, p ANCA, cANCA, CrP, ESR, CBC, Rheumatoid factor, Anti Ds DNA, anti Sm antibodies). X rays to evaluate any degenerative of demineralization lesions at the level of the joints could also be seen. I strongly suggest you consult your rheumatologist and an endocrinologist. Thanks and kind regards, Bain LE, MD.