Discussions By Condition: I cannot get a diagnosis.

Help about diagnosis

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Anonymous
  • March 11, 2007
  • 07:35 PM

I'm 31 years old female and more than a year the doctors can't figure my diagnosis. My child has the same sympthoms few months before me.That's why we made tests for many infectious diseases like Adeno viruses, Enteroviruses and Coxsackie, EBV, CMV, HIV,Parvovirus B19, HBsAg, HCV, syphilis, Yersinia Enterocolitica, Brucellosis, Tularemia, Erlichia, Listeriosis, Leptospirosis,Micoplasma, Chlamidia psitaci, Chlamidia trahomatis, Staphylococcus aureus, Toxoplazmosis,Toxocarosis, Trichinelosis, Ascaridosis, ASLO titers, Q fever, Candida, Aspergilus, "Quantiferon" and TB spot tests for TB. All the results were negative. We have normal levels of ANA, ANCA and Anti-Sm/RNP and for a long time possitive NBT test - nitroblue tetrazolim test, connected with fagocytic activity. We were treated with Cefzil, Augmentin, Clindamicyn, Sumetrolim, Doxicyclin and Isoprinosin, they didn't help. One month course with Rifampicyn and Rimicid helped a lot but not enough.
Our permanent sympthoms are:
1."Needles" (and sometimes small knives) under the skin of the whole body and painful missing fat tissue.
2. Painful lymph nodes on the head (on the neck and behind the ears) and under the armpit and legs.
3. Temperature between 37.2 C- 37.7 C (in me and the child)
4. Pale face and dark cirkles under the eyes
5. Red eyes, feeling of sand in the eyes, watery eyes
6. Problems with nose mucosa and secretions
7. After the 6-th month changes in the friquences and consistancy of feces (often looks like not severe diarrhoea whith small amount of mucus)
8. Gum and lips ulcers
9. Sudden face blushes.
10. Sometimes pain in the joints and bones
11. Sometimes pain in the muscles
12. Sometimes thick fingers of the hands and hard movement in the joint area
13. Dry and sunburned-like skin
14. Pink-brown spot on my hand (from 3 months now) and 2 white spots on the child's body (one of them is not small white area).
15. Pink-violet areas on the skin of the finger's joints on my hands
16. After a month withought antibiotics the child slowly get worse and refuse eating

I had a lymph node extraction. Here is results of histology made by 3 diferent specialists:
1.Slightly enlarged lymph node with preserved structure. The lymph
follicles and the sinuses are outlined. The cellular composition consists of lymphocytes, scanty plasmocytes and epithelium-like cells. Certain proliferation of blood vessels is witnessed, some of which are with thickened wall. Capillaries are witnessed with hyalinized walls and partially or fully obliterated lumen.
CONCLUSION: The most significant witnessed changes are of the blood
vessels, which gives reasons to consider vasculitis with hialinization of small vessels with no recent inflammatory alteration of the walls. The finding
does not allow for nosological definition of the process.
2. The observed picture in the ready-made preparations and in the
additional sections and the special staining (Perls, van Kosa and Cil-Nilson) gives
ground for evaluation as a reactive process. There is certain restructuring
of the lymph node architectonics with development of many secondary lymph
follicles and considerable monocyte-histiocyte proliferation with expressed
phagocytary activity (haemosiderin, calcium, protein matter, and at some
points-erythrophagia. There is slight hyperplasia of the post-cappilary
venules. Some vessels are with expressed celless sclerosis and resemble
Hasalian bodies. The node capsule is fibrously thickened).
The finding ressemles changes typical for dermatopathic lymphadenitis. It
is desirable to look for deviations in the monocyte-phagocytic system
(immunological and cytological) and if other larger lymph node is
available, second biopsy test should be undertaken.
3. Preserved structure of the lymph node with observed vasculitis.
Affected are small and medium-sized blood vessels. In the special microscopy
staining (Aurin-Rodamin) in these vessels are seen moderate number of objects
shining like micobacteria.

Our test results:
1. suppressed cellular imunity (T-limphocytes and B -liphocytes and CD4/CD8 always more than twice of the normal range),
2. Abnormality the T-limphocytes proliferation /not responding of stimulation with gamma interferon, interleukin and others/
3. Possitive NBT-test for about 9 months /now normal/
4. Twice positive skin test or Micobacterium Bovis
5. Negative blood tests (Quantiferon and TB-spot) for TB.
6. Possitive PPD for Micobacterium Bovis and Micobacterium Tuberculosis.
7. Normal blood tests (exept evaluated PLT - 500).
8. Normal CRP (C-reactive protein).
9. Evaluated levels of circulizing immunity complexes for a long time/now normal/
10. Evaluated CPK and FFAA.
11. Normal CT scan of the lungs and abdomen.
12. Normal immunoglobulines levels.

Thank you very much.

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