Initially, I went to the doctor because i felt a swollen lymph node in my neck and he referred me to a surgeon who said it was fine and not clinically significant. I was tired a lot but didnt think much of it. My symptoms later appeared. I had more swollen glands in my body but are very small. My symptoms are sometimes present and sometimes they arent. The symptoms that i generally have is fatigue, I have a rash on my neck ( but the doc said it could be fungus and prescribed meds), chest pain, shortness of breath, headaches, dizzeness, stabbing pain underneath rib-cage, I had difficulty swallowing once , hairloss(not a significant amount) and the rash on my face also known as the butterfly rash ( its sometimes there and sometimes it isnt; if im out in the sun it would appear but my doc says if i had it, it would remain and not disappear and reappear like that). I also lost some weight; i was 101 and now im 95. My labs cbc is normal, cmp/pn-liver ( the bili was elevated slightly and my alpi was low), esr was normal and ana postive 1:40 titer speckled. My doctor said im fine because my esr is normal and its too early to tell. he did refer me to a rheumatologist ( which is a plane ticket away) to get a specialist opinion. My question is if you have a normal esr does that mean you dont have lupus, even with the symptoms? And finally does the butterfly rash stay on your face? Thank You!!!