AP Problems Not Sure What It Could Be

[tcregon]

I’m emailing for a friend that also has AP but doesn’t get online as much and I’m concerned for her right now. She started AP last December and although has gotten better has continued to struggle but in the past 2 weeks; has really gone down hill. The pain has been paralyzing and even the big meds hasn’t helped. She has also thought of going back on minimal pred. She also has RED bumps/blistars on her thighs and has never had anything like that before. She also noticed she seems to have extreme allergies (possibly hay) but in general allergies and has never had them before. She works on a farm but never had allergies before. In the past month she also had to start on synthetic thyroid meds and I just can’t decide if she should do a complete stop on everything to see if it might be the thyroid meds or the minocin. Could this be a lupus induced problem from the mino? I just am not sure what to think. She lives in Alaska so treatment isnt easy but has seen Dr. S last November. Any thoughts, comments or suggestions?

[Maz]

@tcregon wrote:

In the past month she also had to start on synthetic thyroid meds and I just can’t decide if she should do a complete stop on everything to see if it might be the thyroid meds or the minocin. Could this be a lupus induced problem from the mino? I just am not sure what to think. She lives in Alaska so treatment isnt easy but has seen Dr. S last November. Any thoughts, comments or suggestions?

Hi TCregon,

As your friend has just introduced synthetic thyroid hormone a month ago and started going downhill 2 weeks ago, I’m wondering if it might be a reaction to this new med? You don’t mention which med, but yes, there are some thyroid meds that can induce drug-induced lupus, as well as minocycline.

http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutaffects.aspx?articleid=377&zoneid=17

Has your friend been to the doc and had any labs drawn? A 30% or more increase in esoinophils can indicate an allergy to tetracyclines, which could also account for the rash:

https://www.roadback.org/index.cfm?fuseaction=studies.display&display_id=184#Anchor-The-51540

“A marked increase in eosinophils (for instance about 30%) is an indication of an allergic reaction to the drug.”

My best suggestion would be for your friend to call or email Dr. S asap and ask for his insights, also mentioning the new thyroid med. If it were me, I’d also put in a call to my endocrinologist to mention the symptoms and ask about the new thyroid med. Then, make an appt with an immunologist/allergist to have a blood work-up to see what might be the cause of this reaction and to rule in/out drug-induced lupus (DILE). There are certain blood markers for DILE that can be checked for this (see my Progress Thread – link in sig line below).

I hope your friend finds her answers soon. Please let us know how she gets on and send best wishes.

[tcregon]

Maz,
As always thank you so much for your time and insight; we would be lost here without all of you.

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