PPRuNe Forums - View Single Post - UPDATE - Seeking docs to play "House" for real
Old 30th Dec 2009, 16:59
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one day soon
 
Join Date: Mar 2007
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Hi Pitts

My thoughts are with you, however I'm sure as much as you appreciate the best wishes some medical expertise is more valuable so I will hand over to my better half 'Dr One Day Soon'........

Hi, so sorry to hear about your little one. I agree, it may be time to contact someone in tropical diseases for an opinion, but if her signs of a skin colour change started before traveling to Brazil, you may not get answers here either. You do need to double check her bilirubin levels as these would be raised in a haemolytic anaemia (with whatever underlying cause). Her remaining liver function tests as well can give an idea of what else may be going on. I presume they checked a blood film and looked at the nature of the red cells? If this is normal also, then haematological problems may be generally excluded. Have they checked her stools for blood also?

With the issue of mice, it may be wise to ask about a disease called leptospirosis, which is an infection usually caught through rat excretions. It is a long shot, but often presents with a very varied symptoms and therefore gets missed as a diagnosis at the start.

If her bilirubin is normal, you have to consider all the other ways your red cells disappear - bowel is usually the first to consider (hence my comment on her stools) . Is she losing blood in her urine ( is her kidney function ok?) Have they done an ultrasound of her abdomen and looked at her spleen? Is her breathing normal?

Also a very slim chance is an hereditary/genetic issue, are either yourself or your partner of Mediterranean/Latin American/Asian descent? (thinking of possible recessive traits like Thalassaemias).

Sorry for the barrage of information/questions but it seems there are lots of possibilities and without the specific results it is difficult to streamline thought processes.

On the plus side, her bone marrow was normal, which is reassuring. Please try to keep positive, sometimes these things do take time to unfold before revealing the truth, and, fingers crossed this will happen soon. It is always difficult when dealing with hospitals you are not familiar with, but it sounds like you have been on top of things which is entirely the right thing to do. Keep going.

Hope all improves and feel free to contact anytime via this thread or pm and I will pass on the questions/developments, Good luck
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