Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hi doctor,
Before two years, I had some preexisting conditions. I had fibromyalgia, polyneuropathy, macular pucker in both the eyes, hypothyroidism, osteoarthritis, irritable bowel syndrome, diverticulitis, candidiasis, pelvic floor dyssynergia, and arterial hypertension. I had collagenosis and I got it before thirty years with lots of symptoms. But, now I have some symptoms. But my doctor could not able to confirm it and therefore I am not getting treatment for it. I had a tough situation for about seven months with lying in bed.
I had a feeling of a swollen brain, pain in the left side of the brain, chronic fatigue, memory loss, general pains in the body, and difficulty in breathing. I had hypothyroidism with arterial hypertension. It showed me strong variations in blood pressure. I am attaching my reports and please go through them. I have done laboratory tests for MCHC showing positive result, gamma GT showing positive result, alkaline phosphatase showing positive result, IgG showing positive result, IgE showing positive result, CD 21 is low and CD 38 is low, IgM RF shows a positive result, and CD4 shows a positive result. What is wrong with me? When I think I am getting well, I started to have new symptoms in my body. Please help me to proceed with the treatment. What is your diagnosis?
Hi,
Welcome to icliniq.com.
It is impossible for me to give a single diagnosis after reading your history. You can have some form of autoimmune disorder for which autoimmune disease workup can be planned. ANA (antinuclear antibody) investigation can be done preliminarily to check for autoimmune disease. If the blood pressure remains high constantly, then you need to take antihypertensives. You need to do an EMG (electromyography) study for weakness. Fibromyalgia can also cause weakness and dyspnea. Fluoxetine or Amitriptyline can be taken for it. Relaxation exercise and yoga can help you a lot. I suggest you check your vitamin D levels and ionized calcium levels with further workup. You need to consult an internal medicine specialist or neuro physician for the primary workup.
Patient's Query
Thank you doctor,
ANA has been tested and most of the time it showed me a negative result. But sometimes, it shows a positive result of 1:1000 or 1:360. The rheumatologist checked them several times along with other antibodies and showed negative results. The probability of having an autoimmune disease is low for me. Do I need to do other laboratory tests to identify the cause?
Hi,
Welcome back to icliniq.com.
You had already investigated for autoimmune disease. So no need to repeat the tests. You can investigate further with free ionized calcium estimation. Low thyroid levels can also cause weakness and so check your TSH (thyroid-stimulating hormone) again. For weakness, EMG (electromyography) investigation can be done to rule out the muscle problem. For that, you can consult a neuro physician.
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Pathology
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