Re: mysterious illness?

Posted By HFHSM.D.-rf on May 26, 1998 at 23:55:26:

In Reply to: mysterious illness? posted by Alicia on May 20, 1998 at 09:45:48:






Daughter is very ill with undiagnosed illness. Do you have any suggestions of what might be wrong. Doctor is searching for disorder or disease which has these symptoms.
Daughter began having severe migraines at 13 years old ( just after reaching puperty) these would last weeks. Now are under control by taking epival 4x a day. At around 15 years of age she developed severe lower right abdominal pain ( located exactly where appendix is ) pain can be pointed to with one finger, never changes location. This is accompanied with severe vomitting. Food or liquid does not seem to move past stomach. She has vomitted up a melted popsicle 12 hours later.These attacks would last for 1 to 21 days. During this period she also began to suffer depression, always 1 week before her period. During these depressions she would range from suicidal to manic. Has also had times where she has gone pschycotic and confused. She is now 19 years old, over the last 18 months she has become very ill. 18 months ago she tried birth control pills. These seemed to bring on the stomach pain. The attack lasted almost 5 months with just a few days inbetween with no vomitting or pain. At this time she required a gastro- nasal tube. upon stopping the birth control pills she seemed to improve. She was well for 3 months. Last July the pain and vomitting started again. (no depression) she is still in pain and requires narcotics to provide relief. Vomitting comes in bouts lasting anywhere from days to weeks. In October she took 7 grandmal seizures in a 1 week period. These showed seizure activity on an eeg. Now under control with epival. Upon starting mannerix she began taking small seizures resembling mini grand mals. A 48 hour eeg showed nothing. She has now developed iritis in both eyes. She has had scopes done including a colonoscopy. All showed nothing. Blood work, urine, stool, ultra sounds and MRI of head all came back normal. There are times when she is in what nurses say looks almost semi coma like but vitals are all normal, She also has times of mental confusion. During the stomach pain she is also always constapated. any ideas






Dear Alicia,
The gastrointestinal aspect of your daughters illness is very suggestive of impaired gastric emptying.  A gastric motility study will confirm whether she does have gastroparesis.  If delayed gastric emptying is confirmed, several diagnoses must be considered including  diabetes mellitus (sugar diabetes), hypothyroidism, abnormalities of minerals (calcium, magnesium, potassium), medications ( anticholinergics) and drugs.  Has your daughter been evaluated for porphyria?  Finally, it is appropriate to have a better understanding from the neurologist what is happening in the central nervous system
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital and perform the appropriate investigations after we have had the chance to meet you and to review your history in greater detail. You can arrange an appointment with Dr. Fogel, one of our experts in the diagnosis and treatment of complex gastrointestinal disease by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: abdominalpain, vomiting
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