Discussions By Condition: I cannot get a diagnosis.

Eosinophilia and Hypogammaglobulinemia?

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: Anonymous
  • June 14, 2009
  • 05:08 AM

Thanks in advance for your insight and guidance. In March I suddenly found myself with a range of new diagnoses after being completely healthy 45 year old male with no medical history. In March 2009 I was diagnosed with Eosinophilia (40%), Hypogammaglobulinemia low IgG (407) after going to the doctor with stomach pain and alcohol intolerance (0.5 ounce of wine or whiskey would trigger a violent attack within minutes, while grape juice does not cause an attack). Asthma (85% lung capacity), lung granulomas, lung nodules and possible mild Bronchiectasis.

This all occurred after starting a 30 day course of Canasa (Mesalamine) to which I had rash and breathing problems in what seems to have been an allergic reaction and possibly triggered the above problems.

­ I am now on Claritin (10mg), Lexapro (5mg) and Aciphex which together brought relief to stomach pain within hours.
­ Cardiologist sees no Eosinophilic infiltration or Loeffler’s.
­ Repeated Endoscopies show no problems. I am negative for Eosinophilic Gastroenteritis.
­ 3 day stool test for parasites came up negative.
­ Hematologist did bloodwork and Bone Marrow biopsy, but sees no sign of neoplastic disease.

Combining this with the gastric disturbance/attacks (with instant continual relief with Claritin), alcohol intolerance, lung granulomas, lung nodules, sudden onset Asthma, all right after a reaction to Canasa, is an quite a set of symptoms that I think merits a 2nd opinion before going down steroids to control Eosinophilia and/or regular IV Immonoglobulin for the low IgG (note I do not get infections).

My internist feels very uncomfortable with two concurrent diagnoses of very rare disorders (Eosinophilia and Hypogammaglobulinemia). Thoughts? Suggestions?

Warm regards, thanks in advance,

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  • This story has a very happy ending. In March I suddenly found myself with a range of new diagnoses after being completely healthy 45 year old male with no medical history. In March 2009 I was diagnosed with Eosinophilia (40%), Hypogammaglobulinemia low IgG (407) after going to the doctor with stomach pain and alcohol intolerance (0.5 ounce of wine or whiskey would trigger a violent attack within minutes, while grape juice does not cause an attack). Asthma (85% lung capacity), lung granulomas, lung nodules, ground glass opacities. I developed a persistent dry cough. sudden onset Asthma. Histology showed focal necrosis of the colon with eosinophilic infiltrates through all levels of the mucosa. Months later, I started to develop tingling in extremities, shooting pains in hips and joints. -­ Cardiologist saw no Eosinophilic infiltration or Loeffler’s. - Repeated Endoscopies show no problems. I am negative for Eosinophilic Gastroenteritis.-­ A number of separate 3 day stool test for parasites came up negative.-­ Hematologist did bloodwork and Bone Marrow biopsy, but sees no sign of neoplastic disease. My internist felt very uncomfortable with two concurrent diagnoses of very rare disorders (Eosinophilia and Hypogammaglobulinemia). I am now Cured, as of October 2009. I had developed the signs of Churg-Strauss: Persistent high Eosinophilia (27%-48%) for more than six months, tingling in extremities, shooting pains in hips and joints, migrating ground glass opacities in the lungs as well as lung granulomas, lung nodules, sudden onset Asthma and focal necrosis of the colon with eosinophilic infiltrates through all levels of the mucosa. Before being put on Steroids by my Rheumatologist, I was sent to an Infectious Disease expert. Even though I tested negative to Parasites many times, I was given one dose of Ivermectin (a broad-spectrum Antihelminthic (paralyzes and eliminates parasites)). All symtoms disappeared and the Eosinophil level returned to 5%. This was tested monthly for three months. It was apparently a parasite that evaded tests, generating a range of rheumatological symtoms. Even my low IGG has been gradually returning to normal levels. Anyone with a preliminary diagnosis of Idiopathic Hypereosinophilia or Churg-Strauss Syndrome should undergo one treatment with Ivermectin, to rule out a hidden parasitic infection. Especially since treatment for Churg-Strauss involves steroidal immunosuppresent therapy that could prove fatal in the presence of a parasite such as Strongyloides, as autoinfectious parasites such as Stronglyloides florish when the immune system is repressed, leading to rapid infection in atypical organs leading to organ failure. Joel P.
    Anonymous 42789 Replies
    • February 26, 2010
    • 02:41 PM
    • 0
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  • Hello, my brother is being treated for Churg Strauss and I wondered if you could tell me if you have any idea where you 'picked up' the parasite. My brother has horses, donkeys and chickens and thought they might be a connection there. The difficulty is that he is taking steroids and an anti cancer drug to treat the Churg Strauss and he is worried about taking antibiotics at the same time - I think because his liver is already 'under pressure' from the drugs he is taking. It would be a pity if he was taking the steroids unnecessarily. Many thanks.
    Anonymous 42789 Replies Flag this Response
  • Hello,my brother is being treated for Churg Strauss and I wondered if you could tell me if you have any idea where you 'picked up' the parasite. My brother has horses, donkeys and chickens and thought they might be a connection there. The difficulty is that he is taking steroids and an anti cancer drug to treat the Churg Strauss and he is worried about taking antibiotics at the same time - I think because his liver is already 'under pressure' from the drugs he is taking. It would be a pity if he was taking the steroids unnecessarily.Many thanks.There are many ways to get a parasite. They even can burrow through the skin if you walk on bare earth. The scary thing is they can evade detection. Firstly, parasites tend to spawn in cycles. If you get a test when they are not producing eggs, the test won't pick them up. Some have very complex cycles and yet produce few eggs, so a parasite like Strongyloides is easily missed. Lastly, the tests are not done in a reliable and predictable manner by many labs. They often "pool" samples then test the whole set, to save money, perhaps falling back to individual tests if they get a positve. Note also a less than immedate testof the sample can cause result accuracy to erode.For me, the solution turned out to be a single dose of Ivermectin. Western physicians are unaccustomed to encountering parasites, and can miss the diagnosis if you get one or more negatives for parasites. Empirical treatment (treating without a positive parasite test) goes against the western scientific method.If your brother is on immunosuppresives and/or corticosteroids, he is already exposed to the risk of a parasitic takeover, where the parasite is freed by the purposefully weakened immune system to multiply and invade atypical areas of the body. With parasites such as Stronglyloids, this could be deadly.For me, the low IGG (Hypogammaglobulinemia) was likely the result of nutritional deficiency from the parasite (just my guess).Trying a few broad-spectrum anti-helminthics is a good idea, but only once weaned off the immunosuppressives. For me, the drop in EOS% was immediate. Within days my EOS% was back to normal.The Immunologist swore the test results had to be wrong, so they tested and retested, and to their shock, I was and still am totally cured. What could be better than cured?Please send your brother my best wishes for a speedy and full recovery.joel
    Anonymous 42789 Replies Flag this Response
  • I found this article intestesting as my wife was diagnosed over 4 years ago by a local Pulmonologist with CSS. Against all hope, and odds I have kept a watchful eye for anything that might otherwise explain the symptom pattern she showed at the outset. As CSS is supposedly "very rare" it bothered me to some degree that the doctor happened to have at least 4 other patients under his care with that same diagnosis. My wife had some testing for parasites, along with other conditions to be ruled out. In any event she was put on steroids, now on maintenance dose of 9 mg daily. Just recently we found her PCP open to consulting with a collegue who is head of a group of Infectious Disease physicians, to determine a course of action. If there is anything additional you might add to your story it would be greatly appreciated. Physicians are skeptical of anectdotal accounts as a rule, and to some degree that is understandable. In her late twenties my wife lived out of the country, living in the Middle East and travelling the world extensively at times. Contracting some hard to detect parasite is not outside the realm of possibilities. I wonder if being on steroids would make it hard to detect them.
    Hewitt Berrien 2 Replies Flag this Response
  • JoelDo you have an email address I might contact you privately?thanksH. Berrien
    Hewitt Berrien 2 Replies Flag this Response
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