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I just got back from my first ever rheumatologist's appointment and have some questions. I ended up at the rheumatologist after having a positive ANA test (1:640 speckled) in some blood work run by my neurologist. I ended up at the neurologist because I've been having bizarre symptoms for the last 3 months that mostly have to do with the central nervous system. I have tingling and numbness in various places, bouts of vertigo and nausea, short periods of cognitive dysfunction, tremors, muscle pain, fatigue, headaches, sore joints (fingers only), leg weakness, and so on. I was healthy up until a few months ago other than the occasional migraine (with aura). I'm 29, thin, a non-smoker, and have a basically healthy lifestyle. I have 3 small children.

Anyway, the neurologist couldn't figure out my symptoms because I had a normal MRI (brain and spine) and normal EEG. My blood test showed low iron and high blood sugar so I'm taking supplements and am going to be screened for diabetes. The only obvious problem in the exam was that I have polyneuropathy in my feet. I can't feel vibrations or sense temperature appropriately. My feet are often ice cold despite being in a warm environment and I get a black patch on one of them sometimes as well as some discolouration of the whole foot (usually a red/purple colour, especially after having a shower). I also have splinter hemorrhages in my finger and toenails sometimes. My toes get numb as if I had frostbite and recently the skin under my worst affected toe (left foot, big toe) has started to peel and become discoloured (dark with some white splotches). Sometimes that toe aches too.

The rheum. was unable to diagnose me because I don't meet the criteria for lupus (yet). I had negative antibodies on the ENA panel (anti-SM, anti-Ro, etc.) but they hadn't yet run the anti ds DNA one so that's being done now. The doctor felt that I do have a connective tissue disease, but that it will take time for it to fully become expressed because it is presenting in an unusual way. He is also running C3 and C4, and all of the antiphospholipid antibody tests.

So really my question is about APS... can it cause neuropathies and the type of symptoms I am having in my feet? I guess it would be because the blood vessels were affected?

I have had 3 successful pregnancies in the last 6 years, no miscarriages, no blood clots...

Any thoughts would be appreciated!


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