My sister has been sick with a HORRIBLE hacking cough and pain in her left lung, she has a rash on her elbows hands back face and thighs. Her energy level in horrible she gets tired easily. she has hade blood work and 2 ct scans, along with a lung biopsy all of which showed nothing she has been taking prednisone at different doses and as soon as she goes off the cough gets worse. Any ideas?
Thanks for your question on Chat Doctor. By your history and description, I can think of two differential s.1. Bronchial Asthma2. Connective tissue diseases (CTD). So, I advise you to consult pulmonologist and get done1. PUT (Pulmonary Function Test). 2. S.ANA level and if this is high Full ANA profile. In your history, you mentioned that her cough is back with decreasing dose of prednisone, this indicates allergic cough seen in asthma.  So PFT is needed to diagnose asthma. She may need inhaled bronchodilators like LAB (long acting beta 2 agonists) and inhaled corticosteroids (ICS). Inhaled steroids are treatment of choice for asthma. You also mentioned rash on her body, this favors connective tissue diseases. So S.ANA will be helpful in rule out CTD. So consult pulmonologist and discuss all these.