yellow palms and soles

My 22 year-old son is a 9 year kidney transplant recipient.  He is on the usual anti-rejection meds (neoral, cellcept, etc.) and does not have a history of any complications. This summer he moved to Florida.  Two weeks ago he noticed that his palms and soles of his feet had a yellow tinge.  His bloodwork results for kidney and liver function were normal.  The doctors are at a loss to explain the condition.  One possibilty was Gilbert's Syndrome, although his primary physician said his bilirubin results were not consistent with Gilbert's.  He has not changed his eating habits or started a new detergent, etc.  Do you have any suggestions as to where we might look next?

[Alan Rockoff, MD]

Tak:

Yup.  Look at his Vitamin A or carotene intake.  Does he eat a lot of carrots, drink a lot of vegetable juice?  A serum (blood) test for carotene may help clarify things.

Carotenemia is harmless; most kids aroind a year old look a little yellowish, because they eat yellow vegtables and don't metabolize carotene as well.  Adults only get yellow palms if they eat a real lot of the stuff.

Another possibility: the palms and soles may have gotten thicker, giving them a yellowish cast.

Maybe a dermatologist should check it out.

Best.

Dr. Rockoff