Fatigue post RTX

[richard052018]

I've just completed my first 6 month RTX maintenance (1 gram) infusion on 12/11. About a week post infusion, I've been hit with awful fatigue. It hasn't gotten better. I was concerned I was having a flare as early as late NOV (chest congestion, my Wegs started in lungs) but my early December labs were all normal including negative C-ANCA and negative PR3.

Current Pred: 15mg/day, no other maintenance drugs beyond RTX/Pred/Bactrim.

Anyhow, I went to primary care to get more labs drawn this week and I had normal ESR (4), normal CRP (2.1), Hemoglobin dropped from 13.6 to 12.5, and creatinine jumped from 1.17 to 1.28. No blood in urine, and all other blood CBC/CMP stuff was normal. My sinuses are clear but I'm the one oddball that seems to have no sinus activity with Wegs: Dr. Villa Forte herself described my sinuses as pristine.

Primary Care thinks the drop in hemoglobin is what is making me tired.

I'd hate to think I'm having a flare AFTER receiving RTX. At diagnosis in May, I had a negative kidney biopsy and normal creatinine (.94), but once starting RTX the creatinine has bounced between 1.07 and 1.26, with this being the first lab (1.28) that was in the abnormal range (>1.27). With this disease I'm always fearing kidney activity.

Is it possible the RTX is making me tired, or lowering my hemoglobin? Am I over-analyzing my labs: all things considered the numbers are pretty good.

Just concerned because I'm completely run down and I've gotta go back to work on the 2nd. Not a fun way to spend the time off wanting to nap all day.

I know my problems are miniscule compared to others seen on this board, but thanks for letting me vent.