Dr Keyes, its me again. Still here but have more info- syphillis has been r/o. TG! Kidney bx: thin basement membrane disease, but 1 glomeruli showed gobal sclerosis but that was 1 out of ~ 24. Good news, no? Last inpt stay 07/28 (kidney bx done on 07/31/09) bld wk as follows: WBC 16.9 H RBC 5.47H HGB 16.8H HCT 48.9H MCV 89.5 MCH 30.7 MCHC 34.3 RDW 13.3 platelets 301 Auto Diff pass Neut auto 65 lymp auto 28 mono auto 7 eos auto 1 baso auto 0 sed rate drawn at 2000 on 7/28, at 0405 was 10, then at 2230 was 9. Initial U/A mod occult blood, RBC 13, WBC 3, Bacteria mod, squamous epith. 2, mucus rare. CMP: gluc119 H, BUN 7L, Ca 10.2H, Amylase 19L, Na 146 H, Chloride 109H. On 07/30 dev crit low K+ of 2.9l. Hx crit low K+ on last inpt 05/09. Since July have felt much better w/ markedly less fatigue and kid pain, but much worse jt pain and swelling, usually bilat knees, but now lt knee and lt hip worse. 2x knees totally went out on me 2nd x was on asphalt w/ my hands full, fell on lt knee with almost all of my weight, which at this point has become significant! X-ray res: 0 fxs, f/u with PCP, on exam states bilat knees with bursitis/arthritis "lots fluid", wtng for auth for MRI of lt knee /lt hip, lower back is extr pain occ/stiff. 01/09 initial ANA was neg.latest ESR nml. Friend w/ RA says had RA for 10 yrs before it showed up on typical blood tests and that her doctor told her this was not uncommon??? Nxt bld wk for P-ANCA, C-ANCA, CMP, RPR. W/ my own research and labs I am thinking RA or possibly SLE. Other S/S I may have forgotten to mention- alopecia, rash on bilat arms chest and face that look like folliculitis but produce little tiny white cysts, large cystic type lesions on armpit areas, breasts and groin that are like "blood cysts" only contain blood and sm amt of puss, but seem cavernous inside - can insert the entire length of medium safety pin without pain after initial penetration into hole. What do you think Doc?