Hi doctor, I have extreme swelling and pain in both lower legs and feet. I also have severe pain in both hands, on all fingers, both wrists, both forearms,both elbows as well as both knees. It is extremely painful for me to stand and walk. I had a CMP (comprehensive metabolic panel) and CBC done, which showed a hemoglobin of 10.4 and a sedimentation rate of 21. I have had a positive ANA, high C3, C4, and high CRP. I also had protein testing that showed high alpha 1 and 2 and high beta 1 and 2. My IgG was also high. Uric acid was 5.1. I have a strong family history of thyroid disease, PMR (polymyalgia rheumatica), CMT and Wegener's vasculitis. I am currently being treated for blood clots in both lungs reflux, Barrett's disease and anxiety. I take tablet Prilosec 20 mg, Xarelto 20 mg and Celexa 20 mg each once daily, and 50 mg Tramadol twice daily. My rheumatologist told me there is nothing more he can do for me and he considered my test results to be normal. Can you please tell me what could be wrong with me? Thank you.
Hello. I have gone through your history and the blood reports (attachments removed to protect patient identity) along with the photographs you have posted. Kindly get the following tests done: 1. Ultrasound of lower limbs. 2. Lupus anticoagulant. 3. Anti-cardiolipin antibody IgG (immunoglobulin G) and IgM (immunoglobulin M). 4. Beta 2 glycoprotein 1 IgG and IgM. Antiphospholipid syndrome (APS). Please start diuretics. Revert back with the detailed information to a rheumatologist online.--->