Discussions By Condition: I cannot get a diagnosis.

back spasms, shoulder aches, hip ache, and abnormal blood results...

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: sinned69
  • January 18, 2007
  • 06:24 AM

Hi there all.
I'm a NZ'er working in Mainland China, been here 4yrs now, have had an interesting time of it. For those of you who've never been, throw all your pre-conceptions away, this place ranges from very developed through to underdeveloped and everything in between.
OK, so what about me & my health problem???

I'm a male, 41yo. Wt= 90kg, Ht=180cm, BP=130/90, P=68 bpm at rest, T=36.9'C (37.4'C is normal). Don't drink much alcohol, I also don't take medications for anything, and was until recently exercising three times per week. Have no other medical conditions or ailments.

Recently I developed some backpain in mid-December, which I put down to a couple of recent events;
1. Long extended motorbike rides for anything from 6 hours on average through to 12 hours. for increase frequency in through the months of Oct-Nov.
2. Recent flooring and wall painting (mural) work I've been doing for the past month (Oct into mid-December).

The backpain itself is more toward the sides away from the spine rather central pain of the spine. The type of pain is more a spasm or occasional ache. It'd occur during sleep. I'd be woken several times throughout the early morning with my upper back muscles going into painful spasms. no other symptoms initially, & no loss of sensation or motor function.

I went to a local Hospital to have a medical assessment, started out with blood tests; CBC, Liver Function Test, Kidney Function Test, Hepatitis screening, plus Urinalysis, Ultrasound Scan (USS) of my chest, kidneys, liver etc X-Ray of my spine.

In-terms of the X-Ray everything came back normal, no abnormalities noted on X-Ray. The USS showed slight enlarged left kidney, but given that I have a congenital abnormality in that I was born with only a left kidney it kind of make sense that one kidney would be a little larger on a 180cm tall 90kg male.

My other results though were another story... (only included the abnormal results)
tests on 30/12/2006
MO monocytes elevated
HCT hematocrit decreased
PLT platelets elevated
ESR erythrocyte segmentation rate elevated
NEU neutrophils elevated
GLO globulin elevated
A/G ratio albumin/globulin decreased
ALT (SGPT) alanine aminotransferase elevated
BUN blood urea nitrogen elevated
UA uric acid elevated
CRP c-reactive protein elevated
consequently further tests were ordered.
spinal CT = normal
spinal MRI = normal
head-pelvis MRI (all organs & spine included) = normal
(yes two separate MRI's completed on different dates)

by now taking occasional NSAID (Voltalin) prn.

more blood work 3/01/2007...
MO monocytes normal
HCT hematocrit decreased (unchanged value)
PLT platelets elevated (slightly higher than last)
ESR erythrocyte sedimentation rate elevated (slightly higher than last)
NEU neutrophils normal
GLO globulin elevated (unchanged value)
A/G ratio albumin/globulin decreased (unchanged value)
ALT (SGPT) alanine aminotransferase normal
BUN blood urea nitrogen elevated (slightly lower than last)
UA uric acid elevated (slightly higher than last)

more blood work 8/01/2007...
PLT platelets elevated
ESR erythrocyte sedimentation rate elevated
NEU neutrophils elevated
GLO globulin elevated
A/G ratio albumin/globulin decreased
ALT (SGPT) alanine aminotransferase elevated
BUN blood urea nitrogen elevated
UA uric acid elevated
CRP c-reactive protein elevated
GGT Gamma-glutamyl transferase slightly elevated
OSM osmolarity decreased

more blood work 10/01/2007...
GLO globulin elevated
A/G ratio albumin/globulin decreased
ALT (SGPT) alanine aminotransferase elevated
BUN blood urea nitrogen elevated
UA uric acid elevated
CRP c-reactive protein elevated
GGT Gamma-glutamyl transferase slightly elevated
OSM osmolarity decreased
Na sodium decreased

also checked were HIV, Hep A-C, RF, ASO, AFP, CEA, PSA-HYB, Fer, GIIUO,
all = normal or negative.
then checked immunity status...
IgG elevated
IgM normal
IgA elevated
C3 elevated
C4 normal
RF normal
ASO normal

then had special immunology blood serum test sent to special testing lab.ANA, dsDNA, nRNP, Sm, Ro, La, SCL-70, J0-1, ACA, M2, histone, FCT, action, Lamin, PM-SCL, vimentin, NOR-90, pANCA, cANCA, ARPA
... all negative.

by now, so many blood tests, had some treatment using "TEMS" machine to treat muscle spasms, also used hot water bottles at night and tried not to use the NSAID or any medicines, since my liver and kidney having a hard time of it according to blood results...

a couple of other pointers.
recent outbreak of chickenpox in local international school, some of the children I had come into contact with due to my employment, prior to knowing of the outbreak, though I had chickenpox when I was a child, but wondered about shingles, though I didn't have any outbreak/rash. Then heard about Lymes disease, though that didn't seem to fit. (I'd had a bad case of gastroenteritis about 6 years ago in Thailand before clearing up after a week at which time I traveled as planned to Indonesia. In Indonesia I developed ?gout or reactive arthritis to whatever the offending organism was at the time, though I never made the connection. I did seek medical assistance at that time, but it was initially put down to a some kind of insect bite. many types of medications later, and swelling which had progressed from a swollen L) index finger to opposite ankle/foot then later L) knee, until finally an internist at another hospital felt I had contracted typhoid, which was not treated and then had crossed the intestinal membrane and caused a reactive arthritis). Hence the Lymes disease, though it doesn't fit completely.

Back to the current situation at hand.
The back spasms have settled perhaps as a normal progression of whatever I have got, or the week of rehab/physical therapy has helped. I had several days of remission before the aches returned and I found I had to take Voltilin a couple of times since to have an uninterrupted sleep. Also the pain sometimes affects my shoulder muscles and the left side of my neck, with an occasional ache into my buttocks/pelvic region. Doesn’t seem to be the joints as such, but rather the muscles or tendons of these areas. I seem to still have good strength in my arms and legs etc. I've had a couple of occasions where the pain affected the front wall of my chest (intercostal) muscles, where it was painful on inhalation or breathing in. I did have one day where I had an ache of my upper jaw on the right side. Wasn’t a toothache, it was an ache involving a section of the jaw at the roots of several teeth; however it resolved itself after a day.

The Dr's here are unsure of diagnosis, there's no immunologist or rheumatologist, therefore between rehab Dr, orthopedic Dr, internal medicine Dr, all have differing opinions -kind of a guessing game.

I've had these possible diagnosis offered;
-multiple myeloma
-Huppert’s disease (think that’s multiple plasma cytoma of the bones)
-polymyalgia rheumatica

Seek any suggestions or ideas, on what to consider or tests worth pursuing?

any ideas, anyone???

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