I have a dear friend who has been suffering for 8 years with worsening symptoms. She has met with several specialists and none have been able to provide an answer or relief. She is a 26yo, female, underweight and unable to gain. Tachy with low BP 90/60 at rest. O2 at 79% during activity Fatigue and weakness. Back and chest pain Pallor is that of anemia Intermittent rash occuring on neck Normal RBC/WBC. Normal MRI. Renal insufficiency characterized by slightly elevated protein and blood in urine. ANA normal Her Pulmonologist has referred her for a heart cath. I recommended Serum Electrophoresis. Any suggestions are welcome.