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Arthritis (Expert Forum)
Symptoms that have doctors 'stumped'
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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Symptoms that have doctors 'stumped'
by ishamel, Jul 14, 2003 12:00AM
I've had the following symptoms. All doctors--internal, allergists, dermatologists, gastro-- seen have been stumped.
1) Leg/Stomach/Jaw quivering
2) Continual feeling of lightheadedness/fog
3) Persistent pain from the elbow to hand; knee to foot; most intense pain in wrist, knee, ankle
4) irritable bowel symptoms
5) dermographism
All bloodwork, urine, stool has come up fine. So has an MRI of the head/spine, except for some "bulging nerves" in the neck. 24-hr urine test for carcinoid and histamine has been normal. At a loss where to turn next? Wondering if it is generalized anxiety/hyperventilation.
1) Leg/Stomach/Jaw quivering
2) Continual feeling of lightheadedness/fog
3) Persistent pain from the elbow to hand; knee to foot; most intense pain in wrist, knee, ankle
4) irritable bowel symptoms
5) dermographism
All bloodwork, urine, stool has come up fine. So has an MRI of the head/spine, except for some "bulging nerves" in the neck. 24-hr urine test for carcinoid and histamine has been normal. At a loss where to turn next? Wondering if it is generalized anxiety/hyperventilation.
Doctor's Answer
by Kevin Pho, MD, Jul 16, 2003 12:00AM
, Jul 16, 2003 12:00AM
Hello - thanks for asking your question.
Without examining you, it is impossible to say what you have. Especially since you have seen several doctors - it is unlikely that I would come up with something new.
I typed in all your symptoms in a computerized differential diagnosis generator and here are some possibilities that it came up with:
1) irritable bowel disease itself can present in a variety of manifestations. This however is a diangosis that should be made after more serious diseases are excluded
2) inflammatory bowel disease (either Crohn's disease or ulcerative colitis)
3) chronic prostatitis - if you are a male
4) mercury or lead poisoning
5) Whipple's disease - a bacteria causing malabsorption of nutrients.
These diseases should be discussed with your personal physician. Most of them are of a GI variety, so I would probably start with an upper and/or lower endoscopy to rule out inflammatory bowel disease or other overt GI diseases. Tests for Whipple disease or other diseases of malabsorption can also be considered. Mercury or lead poisoning are rarer causes that may be considered if all the other tests are negative.
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.
Thanks,
Kevin, M.D.
Without examining you, it is impossible to say what you have. Especially since you have seen several doctors - it is unlikely that I would come up with something new.
I typed in all your symptoms in a computerized differential diagnosis generator and here are some possibilities that it came up with:
1) irritable bowel disease itself can present in a variety of manifestations. This however is a diangosis that should be made after more serious diseases are excluded
2) inflammatory bowel disease (either Crohn's disease or ulcerative colitis)
3) chronic prostatitis - if you are a male
4) mercury or lead poisoning
5) Whipple's disease - a bacteria causing malabsorption of nutrients.
These diseases should be discussed with your personal physician. Most of them are of a GI variety, so I would probably start with an upper and/or lower endoscopy to rule out inflammatory bowel disease or other overt GI diseases. Tests for Whipple disease or other diseases of malabsorption can also be considered. Mercury or lead poisoning are rarer causes that may be considered if all the other tests are negative.
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.
Thanks,
Kevin, M.D.
Member Comments
by bwan, Jul 28, 2003 12:00AM
Do you get red spots on your hands and feet? Do you have swollen finger tips or joint?
by minnierice, Aug 23, 2003 12:00AM
Hi I'm Lourdes and 42 years old. Have lupus for last 10 years and relatively ingood health, except 1 yaer of chemo for the lupus. I also have fibromyalgia , hashimoto's thyroiditis,osteoporosis and now symptoms are tingling in my wrists,hands and numbness as well. alot tingling and lightheaded in my head. Orthoststic hypotension, tachycardia mostly at night in my sleep that does not let me go back to bed at times.My potassium drops down to a low 2.6 and i'm told that in itself can cause all my symptoms including the chest pain. But no one is doing much to straighten out the problems, this is going on for 4 months now and 8 hospitalizations later with 2 fire resue rides to hospital.Doctors are totally perplexed with me. trust me I hate being in this circumstanceI need to finish nursing school and I start back up next week what to do? Would a mayo clinic visit behove me?
