ANA , Headaches, and Hypertension

I am a 47 yr old woman w/dx of fibromyalgia (12 yrs), chronic cystitis (25 yrs.from intercourse), surgery-induced menopause, MVP, and hypothyroidism (all well-managed);otherwise good health until early '04. Had rarely had a HA & no family history of HBP. Was having nights sweats & severe hot flashes for several mos & began developing pain in jaw & hands. Dx was arthritis. Several mos. later, TSH was 10. (6/04), the daily rt-sided pressure-type HAs began. OTC meds didn't help. Rheumatoligist ordered MRI (was open). Tech called it normal; went to a neuro, who pointed out lesions (didn't tell me she suspected MS). By 9/04 BP was to 170/120, constant tinnitus, nodules on hand joints, oral ulcers, & tingling in hands/feet. Blood tests showed ANA of 1:2560 w/all other tests normal. Neuro continued treating my HA, w/little results. 11/04 pain began in hips/thighs/lower back. Another head MRI (closed) was normal. BP up again;24 hr urine test & Echo were neg. 5/05 blood in urine w/no infection. Referred to Urologist-abdominal/pelvic CT normal. BP up again-referred to nephrologist. LDL up-other tests normal. Pains in hips/legs got worse. Crown of my head is tender to touch. Dr concerned about blood in urine/HBP/HAs-sent me to Mayo to rule out Lupus & ck my kidneys. Tests were normal exc ANA is 1:2560. Dx was possible Lupus. ALT, AST, ALK P, Tbili have increased (2-3x) in past 2 yrs. but at highend of nml Tingling spread to entire body;tenderness on head is spreading;legs sometimes give out. RNP,SCL70,DNA,SM,SSA,SSB,ESR,ALB,CRP,RA are nrml. What should I do next? Insist on LP? Help!

[CCF-Neuro-M.D.-PW]

I cannot give you a clinical diagnosis over the internet, unfortunately

It seems that your primary problems may be non-neurological - the ANA, blood pressure, nondules would suggest a more systemic process going on.  Autoimmune processes can affect teh central and peripheral nervous systems, for instance, your widespread tingling could be related to mononeuritis multiplex, , involvement and damage of several non-contiguous peripheral nerves at one time. An EMG and nerve conduction studies mjight be able to clarify this. It may also give clues as to the level of involvement of muscle in the process. While an LP will probably not be helpful, a muscle biopsy might - biopsy where there is definiteinvolvement.

Good luck

[daz71]

I am a healthy 71 year old male with hypertension.  I have been on medication for 15 years or so and take Covera and Micardis.  I exercise regularly.  My blood pressure readings in the morning especially after exercise are quite low but the readings increase as the day goes on and at night, when I am relaxing, my readings can be very high.  My G.P. doesn't seem to think this is a problem.  It worries me a lot. The other night my B.P. reading was 190/110. What can or should I do?