I think you have excellent reasons to check in with a rheumatologist!
Most rheumies do not require a referral, unless of course your insurance requires one. One way to find one well-versed in Lupus is to check out
www.lupus.org and look up your local chapter. Contact them to see what local rheumies are active on their advisory board -- these are the Drs most experienced with Lupus & similar AI diseases.
Also be forwarned -- some primary care docs think Lupus is easy to treat and will try to handle it themselves. Don't let this happen!!
Cheers,