<s>[INST] Hi doctor, I have had a fever for over a year now. I have joint pain in wrists and awaiting ultrasound guided steroid injections. I have three deformed fingers, premature ventricular contractions, shortness of breath, chest pain, upper back pain, neck stiffness, cracking and pain. I have dry mouth, nose, throat, eyes and now choking regularly. I had surgery for a prolapsed spinal disc and loss of sensation or power to the entire right leg.  Now, I have a rash on my face and neck and unexplained bruises and rashes. My joints crack and creak. My wrist and knuckles swell and turn red. I have ulcers in my mouth and lost weight. My BP keeps fluctuating between 69/49 mmHg and 220/202 mmHg and pulse too remains irregular between 39 bpm and 115 bpm. I also feel fatigue, irritability, aggressive with low vitamin B12. The rheumatologist, who I am visiting once in six months, is not keen to diagnose me. Please help me. [/INST] Hi doctor. 1. ANA (antinuclear antibodies). 2. ENA profile (extractable nuclear antigen antibodies). 3. Complete blood count. 4. ESR (erythrocyte sedimentation rate). 5. Urine routine. 6. Liver function tests. 7. CPK (creatine phosphokinase) and LDH (lactate dehydrogenase). 1. Lupus (inflammatory disease in which immune system attacks own tissues). 2, Dermatomyositis (skin rash, muscle inflammation and weakness). Avoid sun exposure for the time being. Revert back with the reports to a rheumatologist online.---> </s>