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is it automimmune disorder

  . By Lasie74 | Feb 02, 2013
I have been suffering from various non specific symptoms for long time but no definite diagnosis has been made in the context of global picture of symptoms and abnormal lab findings. They are as follows:
Positive ANA with speckled and nucleolar pattern
Positive atypical P-ANCA
Elevated Kappa light chain
erratic blood level of triglycerides from normal to slightly elevated to very high. (no medications)
Chornic skin rash on the side of neck and at the base of head and neck for almost seven years. No treatment has cured it.
Skin biopsy showed acanthotic psoriasiform dermatitis, infiltration of leukocytes looking like lichenified ezema
Difficulty with thermoregulation and severe anhidrosis, hyper-keratinization
severe damage of Post ganglionic sudomotor sympathetic fibers  causing autonomic neuropathy diagnosis of sjogren.
no diabetes
severe insomnia
fleeting pains and aches, inflammatory arthralgia
mucosal lesion which are very painful in mouth and vagina
above problems occurred after uterine fibroids were removed and blood transfusion was received
After blood transfusion, positive for CMV and EBV (only one partner)
short sun exposoure causes unexplained severe fatigue, permanent pigmentation rash and swelling of feet and hands without pitting edema.
QSART test positive for unmyelinated post ganglionic fibers damage
unexplained fever
rapid transition on barium swallow test to rectum in only 15 min instead of an hour.
Severe blurred vision off . Slit lamp exam confirmed punctate cornea. Cyst formation tendency. ganglionic cyst removed. ovaries have some mass or cyst or dermoid cyst
rapid loss of hair, testosterone very low
niacin abnormal.unexplained sweating on face and neck only at night even when it is a freezing temperature.
trigger fingers,
ppd test positive
rare side effects to medications like INH, phenothiazine group, benadryl. demrol, metronidazole and niacin. My research showed all these chemicals have a common thread of having aromatic ring with N and their metabolism is through hepatic Cytochrome P450. Rare side effects experienced were blurred vision, dizziness, loss of appetite; oral dystonia invloving tongue; paradoxical effect, insomnia; its metabolites related symptoms (due to is prolonged half life); dizziness; severe hypotension (blood pressure dropped to 80) and developed rash on arms.
Severe hypoglycemia in the middle of night, causing palpitation, hunger pangs and urge to eat food like banana

Question for : paraneoplastic pemphigus, carcinoid, lymphoma, insulinoma, autoimmune hepatitis, pancreatitis, systemic lupus or mixed connective tissue disorder, autoimmune autonomic ganglionopathy, polycystic ovarian disease, or any cause due to underlying infections.

Precipitating factors: Emotional and psychological distress caused by victimization multiple times; blood transfusion and post hysterectomy. No family history, no social history no smoking no drinking. No other coexisting medical conditions
2 Responses
1711789 tn?1361311607
MEDICAL PROFESSIONAL
Hi there!

Well, this does look like a autoimmune related condition like systemic lupus with possible +/- hormonal/ endocrine issues and few associations such as psoriasiform dermatitis/ lichenified ezema, autoimmune autonomic ganglionopathy etc. It is also true that drugs that follow a common pathway for metabolism may be affected simultaneously in enzymatic defects of the liver, resulting in precipitation of side effects. Management in autoimmune conditions that affect multiple systems is often aimed at symptomatic management and down-regulation of the immune system. At this stage I would suggest consulting an internist preferably at a university/ teaching hospital for a detailed evaluation and suggestion of an appropriate management plan.
Hope this is helpful.

Take care!
Avatar universal
Thank you Dr. Kaul for taking time and responding to my question. Could you please tell me
1. if EBV can precipitate Lupus?
2. Under what circumstances PPD test can be false positve?

thanks
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