Reference no: EM133724153

Question

Sue is a 22 - year - old African - American female who presents with profound fatigue, sore hands and wrists, and frequent episodes of oral and nasal ulcers. She has been told by others that she has a rash across her cheeks when she is exposed to the sun; and she has just begun to notice this herself. Sue describes the fatigue as debilitating, and she finds it difficult to work as a legal assistant. When she is home, she frequently naps; but this never fully relieves her fatigue. Her hands and wrists ache, and this further complicates her ability to do her job as she is expected to type most of the day. She also reports occasional cold sores since she was a teen, but recently these sores have become worse and harder to heal. She has also developed intermittent sores in the nose. Sue reports intermittent episodes of fever, and she has been using acetaminophen to control these episodes. She states, "I just don't have any energy, and I really don't feel well. " Sue' s menses have always been heavy and accompanied by significant dysmenorrhea. The periods started out regular (at age 12) but have gradually.