Protein in urine, Abnormal ESR, hypodense area found in liver

Hello, I hope you can help me make sense of some symptoms I've been experiencing for the past couple of months and some test results I have been given. I'm a 32 year old female and I haven't been feeling well for the past several months. As a background...here are some results I had last year http://www.medhelp.org/posts/Family---Internal-Medicine/High-blood-cortisol--high-urine-creatinine--high-blood-aldosterone/show/1260442?personal_page_id=1457690#post_5774873 I've been experiencing pain in my upper right abdominal area, as well as a lot of tenderness in my ribs on the right side of my body. They are tender to the touch. I often feel pressure and pain under my right ribs. I have also been experiencing stiffness around my spine in the middle of my back. It is a pulling sensation, like a pressure. It is getting uncomfortable to sleep at night. When I lie on my back it feels as if I'm lying on a marble or rock! It feels like something is in my spine. That's the best way I can describe it! I've experienced neck pain and stiffness in my neck for years, but have never experienced any problems in my back before! I went to my doctor and she ordered several tests. In her office my urine tested positive for protein. It tested positive for protein again 2 weeks later. My urine tested neg. for everything else and was sent for a bacterial culture and it came back negative. I did an ultrasound of my ovaries and uterus and they came back normal. I got an abdominal ultrasound and it came back with an area of hypodensity in the left lobe of my liver and it was 3 cm wide. They said that they could not determine what it was in the ultrasound. There were no other abnormal findings on my ultrasound. Kidneys were normal, as was gallbladder. I had blood tests done and the only abnormal finding was an ESR of 30 and my doctor said it was an indication of inflammation. Results from the blood test found that my liver and kidney function were normal. I'm scared of what all this means..help!

[Vaibhav Banait, MD]

Dear violetbaby79,

I understand your health concern and I appreciate your efforts to put in the details of your history and investigations.

I will try to provide you my opinion on your latest health reports. Presence of protein in urine in your case may be regarded as a response to an acute infection. It may be a temporary finding and may not signify anything at all.  Perhaps repeating the urine protein levels along with routine urine analysis as well as serum creatinine, urine protein/creatinine ratio will help us in determining the kidney status better.

However, I feel that the area of hypodensity in the left lobe of liver is the one that should be your primary concern as of now. The high ESR and the pain in your ribs and your back could be all related to the liver issue. I would recommend that you go ahead with the repeat ultrasound to further evaluate this hypodense area. This hypodense area in the liver could be because of an infection, a hydatid cyst or even a tumor. A detailed ultrasound and sampling of the area is required to come to a diagnosis.

Your heart problem does not affect your current health conditions and reports in any way. Yes, alcohol consumption definitely has an effect on the liver and I would recommend you to discontinue it.

I think that you should also get investigated for Pheochromocytoma. You should consider seeing an endocrinologist regarding the same.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Vaibhav Banait

[violetbaby79]

I ran out of space, but my doctor is sending me back to do the ultrasound again of my liver and kidneys and if it is still inconclusive, she will send me for a CAT scan. She is also sending me for an X-Ray of my spine which I plan on doing in the next few days. Also for medication, I'm currently on Propranolol 30mgs. twice a day (if you read the background post I linked to, you will see why I'm on this medication). Any advice you can give is much appreciated! Are my kidney's damaged? What do all these findings together say?

[Hannahmoo]

Hi...Just came across your post while researching my own very troubling symptoms. I sounds as though you were already tested for a Pheochromocytoma?

you wrote: I've been experiencing pain in my upper right abdominal area, as well as a lot of tenderness in my ribs on the right side of my body. They are tender to the touch. I often feel pressure and pain under my right ribs. I have also been experiencing stiffness around my spine in the middle of my back. It is a pulling sensation, like a pressure. It is getting uncomfortable to sleep at night. ....I too, have these same symptoms. Do you have digestive symptoms like acid reflux, heartburn, nausea as well. I do and had this for three years.

I also have been told on separate scans (Ct and MRI) that I have "lesions" on the liver. Most likely hemangiomas. However, the Ct scan saw an 11 mm on posterior right lobe and the MRI done at a different imaging place saw one on the "left" lobe! I am positively confused and terrified that these lesions may be something different.

I have had MVP and palpitations for years but was told my heart is ok. No regurg. to upper chambers. Since my URQ pain under ribs and around to back has started ...along with digestive symptoms, I find that my palpitations are worse.

Do you or have you ever had flushing of face or neck with any of this? I do, but am told it is the beginning of menopause...which of course, you are still too young for.

I was tested for carcinoid cancer...all tests have been negative thus far....butI am still worried. What other symptoms are you experiencing might I ask?

Hope to hear back from you and hope there is someone out there who may have a similar experience! Thanks!