My wife began experiencing flu-like episodes in late 2010. The attacks would present with fever, swollen neck lymph nodes, tight chest/breathing muscles, extreme fatigue, and a “scarlet fever-like” rash primarily on the chest and back. The rash would last a few days and did not seem to spread to the limbs. After the rash would disappear, the other symptoms would continue for weeks. She also experienced mild stomach pain and headaches during the episodes. The episodes were sporadic, with no rhyme or reason to their occurrence. Her overall health, especially her ability to breath, deteriorated after each episode. She was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS) at The Mayo Clinic in July 2011.
Since starting on Enbrel and Methotrexate, her episodes have been less frequent and less severe. Prednisone has proven effective when she does have a “flare”. It is surmised that the underlying condition is autoimmune related, and that her POTS was triggered and made worse by this undiagnosed autoimmune disease. Both her parents have a history of auto-immune disease. Her mother was diagnosed with Lupus and Sjogren’s as a young woman and her father was recently diagnosed with Hashimoto’s and also has a positive GAD 65 auto-antibody.
Amy was diagnosed with pre-mature ovarian failure as a teenager which was thought to be autoimmune related. She was diagnosed with an undifferentiated connected tissue disease in 2001 related to peripheral joint pain. Recently, she was also diagnosed with Hashimotos with a positive TPO antibody and was also found to have a positive GAD 65 auto-antibody.
Testing so far for the fever episodes has proven inconclusive. Some physicians at a local medical teaching hospital, after her case was presented at grand rounds, thought she might have TNF receptor-associated period syndrome (TRAPS), an autoimmune periodic fever syndrome. However, recent genetic testing for this condition came back negative.
She could also have a chronic infection, such as Mycoplasma, Chlamydia or Borrelia. These have a propensity to stimulate autoimmune reactions, and they are commonly found in Sjogren's, Lupus and Hashimoto's Diseases. All of the S/S that you list are consistent with a chronic infection.
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