Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Red blood cell sedimentation rate normal, Sensitive skin, Serum ferritin increased, Swelling, Ultrasound biliary tract
Clinical narrative: I noticed red splotches on my legs starting about the 08/20/2021 from the knee down on both legs. I also started to develop a productive cough that kept getting worse. Finally went to Urgent Care 09/13/2021 to try and find out what was going on with the spots and why cough didn't develop then. 09/20/2021 I went to see my Dermatologist per recommendation due to the weird splotches. Gave me a prescription for a Z-pack for my cough because It was worse and getting worse. 09/21/2021, cough did not improve, finally went back to urgent care sometime in October. 11th or 12th because I was still coughing and red splotches were getting worse On arms as well and were sensitive, swollen and achy. Urgent care doctor couldn't explain anything about the splotches and also said I probably had some kind of bronchitis, only coughing during the day, never at night and always productive. I woke up on 10/24 felt ridiculously sick, went of urgent care and had a CBC done, Urinalysis and Chest X-ray, and the Urgent Care doctor sent my PCP a message about how I needed to be seen as soon as possible. 10/29/2021 saw Dr., urinalysis was clear, lung x-ray clear, c-reactive protein was elevated and liver enzymes were also elevated. Everything else was completely normal. That's when A) I was supposed to go back to Dermatologist for a biopsy because they were getting more painful. B) prescribed Prednisone that I couldn't take until 11/09/2021. Also scheduled for Liver Ultrasound because they were worried about the enzymes and took another blood sample to rule out hepatitis. ALT and AST was elevated and everything else was fine. Liver ultrasound came back normal, nothing wrong with Liver or Gallbladder. Biopsy came back normal, narrowed it down to Erythema Nodosum. That's the possible diagnosis. I have still been coughing that entire time and started the prednisone and finally took care of the redness of the splotches and coughing. 40mg every day for a week. Went back to weight-lifting which caused spots to be irritated in the sense that a couple are nodular and they get hard and hurt (one on each leg) and ankles swelled. We then tried another dose of Prednisone for a longer tapering regime over 12 days and Meloxicam 7.5mg twice daily. Since then, when I lift heavy, it causes my ankles to swell. Usually the meloxicam can control it, but I have periodically taken prednisone to help when the swelling doesn't go away. If my ankles don't go down to a specific size, I have to take it again until it's back to normal. Cough is also coming back and I'm currently waiting to hear from doctor because my spots are not going away and cough is coming back and trying to get an appointment with a gastroenterologist and need to look at my elevated liver enzymes. I also had another blood draw and ferritin was elevated at 450. That's where we currently are. For my blood work, the inflammation markers: C-reactive proteins still elevated, but went down, sed. Rate: back to normal, and liver enzymes were still elevated (done on 12/21/2021). Still ongoing.