After developing severe asthma, a 56-year-old patient began experiencing unexplained symptoms—fatigue, aches, muscle pain, numbness, swollen lymph nodes, and weight loss—but her sciatica left her the most puzzled and in the most pain, according to an article published in The New York Times. The patient reported feeling extreme leg pain when standing or sitting but finding some relief when walking or laying down. She attempted an exercise regimen; underwent a magnetic resonance imaging scan; visited a neurologist; and ruled out cancer, thyroid disease, the human immunodeficiency virus, Lyme disease, and hepatitis—but was still no closer to diagnosing or relieving her pain. Not until she consulted Lakshmi Kocharla, MD, FACR, a rheumatology specialist at Bronson Medical Group, did the patient receive her diagnosis. Dr. Kocharla explained that her symptoms were all related to the same condition: eosinophilic granulomatosis with polyangiitis, a disease characterized by an elevated level of white blood cells that attack small blood vessels across the body. Dr. Kocharla prescribed prednisone to lower her white blood cell count, and after the patient showed signs of improvement, Dr. Kocharla prescribed an immune-suppressing medication. After just 1 week, the patient reported that her pain was gone, she no longer had difficulties sitting or standing, and she could return to work.


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