Dr. Sanjay Kumar Bhattacharyya
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My wife is suffering from irregular and painful periods from more than a year. We went to the doctor, and he told us to perform several tests like serum vitamin, serum prolactin, thyroid function, hemogram, calcium level, and Mantoux test. The reports, which I have attached, showed the level of vitamin D3 and calcium to be low. Her hemoglobin level is 11.5 g/dL, and Mantoux test is also positive. Is it a form of Koch's disease? She was prescribed AKT-4, Ondem MD, Betnesol, and Neurobion forte. But after she started taking them, she has some allergic reaction. Her body has become red, and she has eruptions, which are itching. She has a burning sensation in her stomach. I want to know if this is a reaction to the medicines. What does this Koch's disease mean?
Hello,
Welcome to icliniq.com.
This is a case of irregular, painful periods, which is not uncommon among the woman who has not become a mother yet. I have gone through the report (attachment removed to protect patient identity), but I could not find anything suggestive of tuberculosis (Koch's disease). You cannot start anti-tuberculosis treatment, only if ESR (erythrocyte sedimentation rate) is raised or there is a positive Mantoux test. Yes, vitamin D is deficient here, but that cannot be the reason for irregular periods. All other tests appear normal.There is a need for ultrasonography of lower abdomen. And there is a need for endometrial biopsy to know the nature of the problem. Has she started any form of medication? If no, then I suggest taking combined pill like Ovral-L from the first day of her cycle for 21 days, and then repeat the pack after a gap of five days. The cycle will be regular as well as less painful. This is a contraceptive also, and I know you are not planning for pregnancy now. Get the USG and biopsy done. Stop steroids and ATD (anti-tuberculosis drugs).
Patient's Query
Thank you doctor,
We got an ultrasound of the abdomen already. I am attaching the reports with this query. Is there nothing to worry about the positive Mantoux test?
Hello,
Welcome to icliniq.com.
There is nothing to worry if only Mantoux test is positive. We consider it to be tuberculosis only if the chest x-ray is suggestive of it or sputum is positive, or the biopsy tells that this can be a tubercular lesion.
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Obstetrics and Gynecology
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