I am looking for a diagnosis but I don’t see an apparent constellation of symptoms that exists to explain the issues. I am the patient's sister and a current medical student. I am happy to provide any pertinent information surrounding the patient.
-18 y/o female
-Thin/Lanky stature and high muscle tone (*unusual considering the lifestyle)
-Normal HR, BP, & BR
-No other apparent anomalies
-Unbalanced diet-- lots of carbohydrates ("junk food")
-Does not exercise
-Unemployed Student at a local college
-Does not smoke, drink, or use drugs
-Several early childhood ear infections
-Chronic GI issues: irregular connective tissue that was removed during an appendectomy; blood in stool (initially thought to be endometriosis, ruled out); frequent hemorrhoids
-Kidney Stones (2 passed in July 2010)
-Irregular Menses (~3/year)
-History of sexual abuse
-Severe reactions to benzodiazepines and allergic to penicillin
-Multiple stays in the pediatric and adult psychiatric wards
Lab: (more to come)
-Irregular FSH levels
-Extremely low vitamin D levels
-Microcytic Anemia detected
Behavioral Issues: (in each behavioral case, onset was seen before the abuse occurred)
-Attention Deficit Disorder
-Diagnosed with Narcissism
-Self-Destructive Behavior (bangs her head on the floor when frustrated)
-General immature behavior
Ruled Out Dx:
-Autism Spectrum Disorder
Pt. refuses test for Pelvic Inflammatory Disease or any internal exam for that matter.
Is there a GI issue that would explain the physical and behavioral symptoms?
Thank you in advance for your help!
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