Gastrointestinal problems couplde with elevated IgA, low calcium, low TSH

[JJMartin]

Hi

I'm hoping to find some answers to a medical issue I have been having for about a year now. I'm not sure where to post this as I don't know what the problem actually is. If you could point me in the right direction it would be much appreciated. I'm a 29 year old male living in Melbourne, Australia.

A year ago I developed inflammation in my nasal passage and I was constantly coughing up small amounts of thick clear mucus. The mucus feels like it is constantly there and has a consistently similar to glue. After seeing a couple of ENTs I was simply told nothing sinister but wasn't given an actual diagnosis. My GP treated me with many things including :

serval difference course of antibiotics (some that went for months on end),
anti fungal medication
PPIs.

More recently I have been experiencing a few other symptoms including lighter coloured stools and what looks like clumps of fat in my stool. When I wake up I feel sick until I eat. Also, when taking the PPI I develop a really bad case of gastritis. This was confirmed by endoscope that noted gastritis in the antrum - confirmed on biopsy with a note to say it was checmical/reactive reflux. A follow up endoscope a month later showed the gastritis appeared to be gone but they noted bile in my stomach and biopsies of my distal oesophagus showed mild esophagitis that was not visible on scope by the GI. He said it is very mild. I have been experiencing what I think is reflux after every meal. I eat and immediately start burping a lot over the course of the next hour or so. Beyond 1 hour it will still be happening but is not as severe. I also have a fair bit of gas at the other end too. I have googled this and only come up with bile reflux which on consult with a second GI said he does not believe this is what I have and said it was functional dyspepsia. I was sent away with more PPIs.

I have had quite a number of tests undertaken which have mostly come back normal. Aside from the following:

Elevated IgA
Low calcium
Low Thyroid Stimulating Hormone (TSH)

I don't know what my next course of action is here. What does elevated IgA mean. I looked it up and it basically refers to multiple myeloma which I know my grand mother has and passed away from. When I read about this condition more it typically results in higher than normal levels of calcium not lower. Any advice would be great.

Thanks
J.

[JJMartin]

Ok so I have some more information on this and would really appreciate anyone with any insight on this.

Further testing has shown I also have elevated Amylase (Lipase is normal). My GP retested a month later and it was still elevated. It is in excess of 7 times the upper limit. I have had an abdominal CT (clear), an MRCP (Clear), HIDA scan (lear but noted "features of gastric bile reflux").  It also does not explain why my amylase is elevated. My GI said bile reflux would not cause this.

My GP and GI don't know what to do. It seems I have bile reflux but I don't have a known cause - I haven't had any abdominal surgery and still have my gall bladder.

I would really appreciate if some could shed some light on what is happening and what I should do.

[JJMartin]

Thanks for your reply SassyLassie.

I'm lactose free as my wife is lactose intolerant. I am taking Yakult every day. I have asked my GP and my GI but they have absolutely no idea.

I've had so many tests and nothing comes back with any resolution.

Celiac - negative
Bunch of autoimmune bloods - all good except IgA
Liver function, kidney function - within normal limits.
Allergies - negative
Endoscope - gastritis (bile seen in stomach)

Could the bile in my stomach be causing all of this?

[SassyLassie]

Hello from across the ditch, New Zealand. I am sorry you are going through so much discomfort.

I did a little searching on the elevated IgA, one article described a patient that had some of your similar symptoms, seemed the patient was lactose intolerant. He, too, had sinus conditions, and bowel issues. The writer goes on to say that elevated IgA has  a total of 48 different diagnoses. They are divided into infections, neoplastic disorders, autoimmune disorders, neoplasms, congenital disorders, immune deficiencies (e.g., Wiskott-Aldrich, et cetera), poisonings (acute alcoholic hepatitis), and gastrointestinal diseases such as gluten enteropathy.

Have you talked to any other physicians about this? Have you tried drinking Acidophillus milk or taken a pro-biotic, maybe your system needs some "friendly bacteria."

Hope you feel better soon.