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Gastroenterology (Expert Forum)
I need to know if these two things coinside....
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
I need to know if these two things coinside....
by bamagirl, Nov 10, 2004 12:00AM
I am a 31 yr old wf accountant who has been ill on and off for the past four years. It started out with episodes of tachycardia and insomnia in the middle of the night. I would go to bed feeling "wired" like I had taken sinus medicine or something and then wake up in the middle of the night with severe palpitations that would last most of the night. I am not stressed at all so I knew it wasn't a panic attack. I wrote it off as too much caffeine and would always go in to work the next morning. The next episode happend while I was driving. I had a cool rush come over my body and then palpitations again for most of the day. I also was very wear and had severe diarrhea. After that, I went down hill. I was so waek I couldn't hold my head up. I had to take a leave from work. I had every test imaginable and all were negative except a holter moniter which was capturing sinus tachycardia in the 150 to 160 range even while laying down. Finally I quit going to doctors and just quit work feeling horrible every day. All the while I would have these strange episodes of tachycardia. Then the episodes would get worse. I would feel a rush go over my body, then palpitations, then weakness, then nausea & diarrhea, then the next day I would have a stinging sensation all over my arms and legs like ants were biting me. I finally went to Vanderbilt University for some research studies and they discovered that I have very high methylhistamine levels in my urine(394). I was wondering, are all of these episodes the same? Sometimes I get naseaus, flush, then have palpitations and fatigue. Other times I have a cool sensation go over my body, then get papitations and the next day wake up with a stinging sensation on my arms and legs. I just want to know if all of this is one illness or two different things.
Doctor's Answer
by Kevin Pho, MD, Nov 11, 2004 12:00AM
, Nov 11, 2004 12:00AM
Ths symptoms are certainly suggestive of a histamine excess - which can cause flushing, palpitations and fatigue. The high methylhistamine levels in the urine can be suggestive of one of these diseases - namely, mastocytosis. GI symptoms of this can include abdominal pain, diarrhea, nausea, vomiting, peptic ulcer disease, and gastrointestinal bleeding.
To further diagnose this, a bone marrow biopsy can be considered to evaluate for abnormalities that can affect the marrow.
Carcinoid syndrome can also be considered, and has been discussed in the comments below. Testing the urine for 5-HIAA is another test that can be considered to pin down this diagnosis.
These options should be discussed with your personal physician or gastroenterology specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
To further diagnose this, a bone marrow biopsy can be considered to evaluate for abnormalities that can affect the marrow.
Carcinoid syndrome can also be considered, and has been discussed in the comments below. Testing the urine for 5-HIAA is another test that can be considered to pin down this diagnosis.
These options should be discussed with your personal physician or gastroenterology specialist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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