Dr. Borigini: If there is truly swelling in the muscles, and no explanation for it, if there are no contraindications, your doctor might consider a muscle biopsy. But I feel that a rheumatologist first must perform a thorough examination. If there is a persistently elevated white blood cell count, then perhaps, too, an evaluation by a blood specialist is in order.
While one can see a rash in lupus, muscle swelling and an elevated white blood cell count are not part of the eleven criteria for the diagnostic classification of lupus.
Finally, anytime a patient is experiencing unusual symptoms that cannot be explained easily, one must always be concerned about the possibility of an associated malignancy. At the very least, an age-appropriate cancer screening should be performed (such as breast and pelvic exams, and mammogram).
Important: We hope you find this general medical and health information useful, but this Q&A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.