Q: My 40 years old wife weighs 74 kg. She is experiencing muscle pain, low grade fever, rashes on her forehead and neck and loss of weight. A year back, trace protein urine, ANA was negative, DSDNA - negative, anti CCP antibodies was also negative and C reactive protein was normal. TSH is normal, ESR – 27, complete blood count is normal, liver profile is also normal. The rheumatologist diagnosed fibromyalgia. Why is my wife suffering from rashes?

A:Rash does not fit in with fibromyalgia. Check on the following: 1. CPK 2. ANA-IF and ANA-LIA, VASCULITIS-LIA PANELS, P-ANCA, C-ANCA, 3. ACE LEVELS 4. SKIN AND MUSCLE BIOPSY 5. CHEST XRAY AND USG ABDOMEN 6. 24 HOUR URINARY PROTEIN AND CREATININE CLEARANCE