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Hematology/Undifferentiated Connective Tissue Disease???

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I have summarized all of my blood work in hopes of making sense of it. Only the out of normal range tests are listed.  I had extensive blood work ordered by an ENT, Rheumatologist, Immunologist and my primary with results in the normal range.

The rheumatologist started me on plaquenil but after 4 weeks I developed a rash. Plaquenil was stopped and I was put on prednisone for two weeks.

The immunologist wants to do a desensitization protocol for the plaquenil. The rheumatologist doesn't feel that there is enough evidence of lupus, undifferentiated connective tissue disease or a related disease to do a desensitization protocol. I am taking singular, xyzal, advair, a calcium channel blocker, cymbalta and anti acid.  

I have had chronic sinus inflammation, post nasal drip, reactive airways for 40 years.  I am 9 months post large pericardial effusion (biopsy of pericardium showed chronic and acute inflammation and rare eosinophil). The past 16 months, I have had fatigue, mild to moderate brain fog, rashes that come and go, flushing, mild restriction in the lungs (no asthma) with intermittent feeling that I can't get a good breath and significant early onset bone spur formation throughout my spine.

The blood work appears to be all over the place.  Could this profile be indicative of Undifferentiated Connective Tissue Disease or something else?

1/23/2014
Elevated
complement c4, serum 44 9-36
homogeneous pattern ANA 1:320
vitamin d, 25-hydroxy 21.1 30.0-100.0

Normal
rheumatoid factor
rnp antibodies
sjogren's ab, anti-ss-a/-ss-b negative
anti-dsdna antibodies
smith antibodies
C reactive creatinine
sed rate
adolase

12/31/2013
High
rdw 15.9 12.3-15.4

Low
vitamin d, 25-hydroxy 17.1 30.0-100.0 ng/mL
mch 26.2 26.6-33.0 pg


9/2013
Elevated
immunoglobulin e, total 704 0-100
complement, total (ch50) >63 22-60
rdw 19.3 12.3-15.4
% nk (cd56/16) 21.9 1.4-19.4 %
rbc 5.29 3.77-5.28

Low
mcv 76 79-97
mch 25.0 26.6-33.0





AUGUST 2013
Elevated
RDW-CV 19.6 11.5-15
ANC 7.57 1.45-7.5
ABS MONO .95 0-.86
IGE 813.0 less then 114
Low
mcv 74.4 80-100
mch 23.3 26-34

July 2013
Elevated
Test Low Normal High Reference Range Units
antistreptolysin o ab 388.4 0.0-200.0 IU/mL
ab nk (cd56/16) 408 24-406 /uL
% nk (cd56/16) 20.4 1.4-19.4
rdw 16.9 12.3-15.4 %
sedrate- 57 0-40 mm/h
c-reactive protein, quant 6.3 0.0-4.9 mg/L

Low
complement, total (ch50) >60 22-60
vitamin d, 25-hydroxy 29.0 30.0-100.0
mcv 70 79-97 fL
mch 21.8 26.6-33.0 pg
mchc 31.1 31.5-35.7 g/dL

June 5, 2013
Elevated
alt (sgpt) 55 0-32 IU/L
bun/creatinine ratio 28 9-23 1
eos 13 0-7 %
eos (absolute) 1.1 0.0-0.4 x10E3/uL

Low
mchc 30.7 31.5-35.7 g/dL
mch 22.4 26.6-33.0 pg
mcv 73 79-97 fL


April 26 2013
elevated
% nk (cd56/16) 22.2 1.4-19.4
Immunoglobulin e , total 3215 0-100 IU/mL
complement, total (ch50) >60 22-60

Low
hemoglobin 9.9 11.1-15.9 g/dL
hematocrit 31.8 34.0-46.6 %
mcv 78 79-97 fL
mch 24.2 26.6-33.0 pg
mchc 31.1

April 11, 2013
elevated
aldolase 9.3 1.2-7.6 U/L
c-reactive protein, quant 20.8 0.0-4.9 mg/L
sedimentation rate-westergren 43 0-40
complement c3, serum 185 90-180
beta globulin 1.4 0.6-1.3 g/dL
monocytes 15 4-13 %
complement c4, serum 72 9-36 mg/dL Adult
bun/creatinine ratio 27 9-23

Low
mcv 78 79-97 fL
mch 25.6 26.6-33.0 pg
vitamin d, 25-hydroxy 22.1 30.0-100.0 ng/mL

April 8 2013
High
bun/creatinine ratio 27 9-23
monnocytes 15 4-13
complement c4, serum 72 9-36
beta globulin 1.4 0.6-1.3 g/dL
complement c3, serum 185 90-180 mg/dL Adult
sedimentation rate-westergren 43 0-40 mm/hr
c-reactive protein, quant 20.8 0.0-4.9 mg/L
ladolase 9.3 1.2-7.6 U/L

Low
mcv 78 79-97 fL
mch 25.6 26.6-33.0
vitamin d, 25-hydroxy 22.1 30.0-100.0 ng/mL

3/28/2013
Elevated
c-reactive protein, quant 5.6 0.0-4.9 mg/L
anti-dna(ss)igg, ab, qn 119 0-19 EU
ebv ab vca, igg >8.0 0.0-0.8
ebv nuclear antigen ab, igg 4.2 0.0-0.8

Normal
ferritin, serum
creatine kinase,total,serum

CONSISTENTLY ELEVATED
aldolase
c-reactive protein, quant
sedimentation rate-westergren
immunoglobulin e, total elevated most of the time
complement, total (ch50)
complement 3 and 4
rdw
% nk (cd56/16)
rbc
bun/creatine ratio
anti-dna(ss)igg, ab, qn 119 0-19 Elevated - ONLY TESTED ONE TIME
homogeneous pattern ANA 1:320 elevated one time 1/2014
elevated eosinophil

mcv consistently low
Mch consistently slightly low
Vitamin D- consistently low

Answer
Roxy,
I think we discussed this before, right? For me its clearly Undifferentiated COnnective tissue disease. Plaquenil doesnt usually cause rash as 'adverse reaction'. Anyway I strongly recommend going ahead with desensitization protocol.

Thanking you!

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