Lupus (SLE) & Antiphospholipid (APS)

Clinical Pathology > Musculoskeletal & Dermatologic Pathologies > Lupus & Other Rheumatologic Disorders

Q. A 50 year-old woman presents with diffuse pain and fatigue for at least the past 6 months. Exhaustive work-up rules out a known rheumatologic, endocrinologic, neurologic, infectious, psychiatric or other disorder that can be dismissed through objective testing. Which of the following is the MOST appropriate next step?

Trial of duloxetine, a tricyclic antidepressant (TCA), or anticonvulsant with/without psychotherapy for pain reduction.
No further treatment, she does not have a known illness.
Psychotherapy for pain reduction; there's no role for medication therapy if no identifiable illness can be identified.
Trial of duloxetine, a TCA, or anticonvulsant; there's no role for psychotherapy if no psychiatric disorder can be found.
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