Which Medical Specialty Should You Consult After Abnormal Health Check Results? - Internal Medicine

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Based on your health check results and the symptoms you are experiencing, it is crucial to approach your situation with a comprehensive plan. Given your history as a hepatitis B carrier and the various abnormal findings in your recent tests, consulting with a specialist in rheumatology and immunology would be a prudent first step. This is especially relevant considering your previous diagnosis of systemic lupus erythematosus (SLE), which can have systemic implications and may affect multiple organ systems.


Why Consult a Rheumatologist?
1. Autoimmune Considerations: Your history of SLE indicates that you may have an autoimmune condition that could be contributing to your symptoms. A rheumatologist specializes in diagnosing and managing autoimmune diseases, and they can evaluate whether your current symptoms are related to SLE or if there is another underlying condition.

2. Comprehensive Evaluation: The rheumatologist can review your abnormal lab results, including the elevated white blood cell count and the presence of eosinophils, which may suggest an inflammatory or allergic process. They can also assess your kidney health in light of the calcium deposits noted in your ultrasound, as kidney involvement can be a concern in autoimmune diseases.

3. Management of Symptoms: Given your symptoms of fatigue, pain, and discomfort, a rheumatologist can help manage these issues, potentially prescribing medications to alleviate pain or inflammation. They can also coordinate care with other specialists if needed.


Additional Specialists to Consider
While starting with a rheumatologist is advisable, you may also need to consult other specialists based on your symptoms:
- Nephrologist: If your kidney function or the calcium deposits become a concern, a nephrologist can provide specialized care for kidney-related issues.


- Hematologist: Given the abnormalities in your blood counts, a hematologist can evaluate for any hematological disorders, especially if you experience symptoms like fatigue or unusual bleeding.

- Gastroenterologist: If your abdominal pain persists or worsens, a gastroenterologist can assess for gastrointestinal issues, especially since you have mentioned pain in the upper abdomen.

- Cardiologist: Since you have experienced symptoms like chest tightness and palpitations, it may be beneficial to consult a cardiologist to rule out any cardiac issues, especially given your abnormal EKG findings.


Follow-Up and Coordination of Care
When you visit the rheumatologist, bring all your recent lab results and imaging studies. This will help them make a more informed assessment. It’s also essential to communicate all your symptoms clearly, including the pain in your back, shoulders, and abdomen, as well as any changes in your menstrual cycle or breast tenderness.

The rheumatologist may decide to perform additional tests to clarify your diagnosis and may refer you to other specialists as needed. It’s not uncommon for patients with complex symptoms to see multiple specialists, but having a primary doctor or rheumatologist coordinating your care can streamline the process.


Conclusion
In summary, starting with a rheumatologist seems to be the most appropriate course of action given your history of SLE and the complex nature of your symptoms. They can provide a thorough evaluation and guide you on the next steps, including any necessary referrals to other specialists. It’s essential to address these health concerns promptly to ensure proper management and to alleviate your worries about potential serious conditions.