Discussions By Condition: I cannot get a diagnosis.

Anion Gap acidosis, lactic acidosis, intermittant respiratory failure. hypoxia. HELP!

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: xomissmelxo
  • January 4, 2012
  • 08:10 PM

I cannot get an answer, and it's beginning to get frustrating.

since I was 15 I Was told I was an asthmatic (never wheezed).. only to be told shockingly at 28 years old i'm NOT an asthmatic.

In october this year I started experiencing severe shortness of breath and hypoxia (we are talking PO2 of 50 on a NRB mask) and I became fatigued during this episode, and eventually lost breath sounds, had severe muscle weakness and was intubated. Come to find out during this episode I had a pretty striking anion gap acidosis with a normal blood sugar. As soon as I was put on the ventilator everything started to correct and I was easily ventilated pointing to a muscle weakness. A CT scan hinted at pneunomia so I got rochephin for a few days as well. I also had severely low phosphorus at 1.1, and needed magnesium and potassium frequently.

I corrected from this and went home with perfectly normal blood gas, PFT's and blood work.

Two weeks later I started with severe wheezing that you could hear across the exam room, low pulse oximetry and was subsequently again admitted to the hospital. I again had metabolic acidosis with a respiratory compensation (very low PCo2 and tachypnea) and hypoxia. This time while I was in this episode, a lactic acid level was drawn and turns out to be 4. I had periodic issues with muscle weakness, pain and cramping in my thoracic cavity with a nif of 29 and needed rescue cpap on three occasions my FEV1 dropped to 68%
. Further PFT's once I seemed to recover showed I have a normal flow loop and PFT's while sitting or standing (Back to 103%) but if I lay down they crash over 45% which they think is a weak right diaphram.

I had ptosis for a day while there, and led to testing for various neurological disorders including myasthenia gravis which were negative. I did have amion acids rampant in my urine, ketones in my urine. My pyruvic acid level was over 400.

Everyone is scratching their heads, upon leaving the intensive care unit I still only had a po2 in the 70's on 2lnc. but over time I slowly recovered again and felt better. They found after all the tests I:

1. had a common cold (a common COLD put me in intensive care. no joke!)
2. had a vitamin D deficiency and a B12 deficiency (now corrected)
3. my hypothyroid was borderline controlled.

MRI, CT were normal. Had a EMG that showed some ulnar neuropathy but otherwise normal.

A month later, I came down with tonsillitis, which immediately set me off again into metabolic acidosis with a respiratory compensation (PCo2 of 15).

And recently I started feeling short of breath again with a lactic acid level of 1. Sodium bicarbonate was tried after seeing all this acidosis and it works, taking 650mg three times a day keeps the tachypnea and muscle weakness at bay.

But why?!??!

THe only guess is that I might have a mitochondrial myopathy which would explain the acidosis that only popps up when i'm sick or stressed.

Anyone else struggling or seen this before. I'm so frustrated!!

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