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Abdominal Pain, Dry Heaving, Low Platelet Count, Negative Hepatitis And Viral Load Test For HIV. Is It Lyme Disease?
Question: I'm a 43 yr. old white male from the Chicagoland area. I have been athletic and healthy my whole life until Nov. 20,2011. I do not smoke or take any drugs. I don't really take any medications or even aspirin. I am more of a weekend drinker. Here's my story. On Saturday Nov. 20,2011 i went out to dinner with my wife and another couple. I returned home and a few hours later i woke up about 1 am with severe abdominal pain and dry heaving.The pain lasted a the whole day and by monday felt like it was starting to go away.The next day on tues., I took my family to the Bahamas for Thanksgiving and on the night before(WED) i had another episode. This time along with the severe abdominal that woke me up again around 2am. I was experiencing violent vomiting and diarrhea for hours. This pain lasted the whole day and maybe after 24 hrs. plus started to feel like it was going away again by Fri. Just over 2 weeks later on Mon. Dec.12,2011 i woke up in the early am ,maybe 2 am again with the 3rd episode.This time was like the first with severe pain in my abdomen and dry heaving. The pain always felt maybe a little to the left of my belly button.I went to the ER that morning and the took blood,urine and a CT scan. They gave me antibiotic for what appeared to be possible inflammation in the small bowel & pain medicine.The next day I went to see My Family Dr on tues Dec. 13th where he switched my antibiotics. After i took them for the first time that late afternoon around 4ish i later had black stool, did'nt notice any foul oder. took the antibiotics again that night around 11pm. went to the bathroom again later that night and still black.On Dec. 21st I went up north to see a GI Dr. for examine. He noticed from my ER test results that my platelet count was real low 53,000.My abdominal pain was very mild by this point and i haven't had anymore more attacks since. Now we were on the search of why my platelets were low.. I had more blood test and the platelets went down a little from 53,000 to 50,000.I know went to see a Hematologist about my platelets on Dec. 27th 2011. That Dr. did not feel based off the other test that my liver or spleen were the cause. She also felt the pancreas enzymes looked normal. We did more blood 2 weeks later. At this point i have been off the meds since Christmas Eve and haven't taken anything since XXXXXXX 9th,2012 I went to see My Family Dr. again,this time about my heart cause i was waking up with a racing heart. Maybe cuz' the stress. Only happened in my sleep and would stop racing a minute after waking up.
Took an EKG test and didn't see anything abnormal but did send me to wear a Holter for 24 hrs. to monitor heart activity.Everything with my heart checked out okay. XXXXXXX 11th,2012 wed. The Hematologist called to say the blood looks good but the platelets dropped again for the 3rd test in a row,down to 45,0000 from 50,0000 and the HIV blood test was negative. I looked at a past history of my platelets and 3 yrs. ago they were at 189,000. XXXXXXX 16th 2012 , I went in for a bone-marrow biopsy.They took Marrow,Bone fragment & Blood. I also went to the lab for more blood work for Hepatitis Test and a Viral Load test for HIV. Results came back negative on all but the platelets remained at 45,000. XXXXXXX 20th 2012 fri. My joints have been sore for maybe close to 2 weeks and my neck is a little stiff.My left knee which is bad to begin with is making it difficult to walk.Very sore.Joint Aches lasted about 3 weeks. XXXXXXX 30th tues. I went to GI Dr for a scope down my throat. I went to him a year earlier for a colonoscopy due to my father having a small amount of colon cancer. My results were negative and my scope was as well.Feb 15th 2012 my Platelets went up for the first time from 45,000 to 54,000. March 15th 2012 thurs. Platelets up again from 54,000 to 60,000. April 13th 2012 results down from 60,000 to 57,000. Sun April 22nd my hands and feet are starting to tingle and ache.This is still continuing today and has been about a month now.May 15th 2012 tues. I went to see my Family Dr. about the tingling in my hands and feet & He ordered more blood work. I tested Positive XXXXXXX Low Vitamin D (22.3), and platelets slight drop again from 57,000 to 55,000. I am now told to see a Rheumtologist. My b12 normal,metabolic normal, thyroid normal, Rheumatoid arthritis negative. They want me to go check for possible Lupus. I have NO skin rash. I do have an uncle that has MS. Right now to recap,i haven't had no fever,no rash,no abdominal episodes since Dec, the platelets have remained low between 30,000 and 60,000, I am very fatigued and taking afternoon naps cause the lack of energy.My feet are still tingling for about a month now, my hands are not as bad but a little joint pain.Sometimes i feel that I have to think about recent events more than usual. That my memory at times is a little blurred. Occasionally my neck and back get stiff. Before Nov 20,2011 i felt 20 yrs. younger. Ever since that night out to dinner,it went all downhill. One thing that a few friends brought up is Lyme Disease. I do live near a farm and there is Deer in the area. I have seen ticks in my backyard before and have had one on me before. I haven't noticed any bites or rash but thought there may be a possibility since everything i see online about sounds similar. It's been 6 months so far and the frustration and stress of not knowing is killing me. Thank You, XXXXXXX
Took an EKG test and didn't see anything abnormal but did send me to wear a Holter for 24 hrs. to monitor heart activity.Everything with my heart checked out okay. XXXXXXX 11th,2012 wed. The Hematologist called to say the blood looks good but the platelets dropped again for the 3rd test in a row,down to 45,0000 from 50,0000 and the HIV blood test was negative. I looked at a past history of my platelets and 3 yrs. ago they were at 189,000. XXXXXXX 16th 2012 , I went in for a bone-marrow biopsy.They took Marrow,Bone fragment & Blood. I also went to the lab for more blood work for Hepatitis Test and a Viral Load test for HIV. Results came back negative on all but the platelets remained at 45,000. XXXXXXX 20th 2012 fri. My joints have been sore for maybe close to 2 weeks and my neck is a little stiff.My left knee which is bad to begin with is making it difficult to walk.Very sore.Joint Aches lasted about 3 weeks. XXXXXXX 30th tues. I went to GI Dr for a scope down my throat. I went to him a year earlier for a colonoscopy due to my father having a small amount of colon cancer. My results were negative and my scope was as well.Feb 15th 2012 my Platelets went up for the first time from 45,000 to 54,000. March 15th 2012 thurs. Platelets up again from 54,000 to 60,000. April 13th 2012 results down from 60,000 to 57,000. Sun April 22nd my hands and feet are starting to tingle and ache.This is still continuing today and has been about a month now.May 15th 2012 tues. I went to see my Family Dr. about the tingling in my hands and feet & He ordered more blood work. I tested Positive XXXXXXX Low Vitamin D (22.3), and platelets slight drop again from 57,000 to 55,000. I am now told to see a Rheumtologist. My b12 normal,metabolic normal, thyroid normal, Rheumatoid arthritis negative. They want me to go check for possible Lupus. I have NO skin rash. I do have an uncle that has MS. Right now to recap,i haven't had no fever,no rash,no abdominal episodes since Dec, the platelets have remained low between 30,000 and 60,000, I am very fatigued and taking afternoon naps cause the lack of energy.My feet are still tingling for about a month now, my hands are not as bad but a little joint pain.Sometimes i feel that I have to think about recent events more than usual. That my memory at times is a little blurred. Occasionally my neck and back get stiff. Before Nov 20,2011 i felt 20 yrs. younger. Ever since that night out to dinner,it went all downhill. One thing that a few friends brought up is Lyme Disease. I do live near a farm and there is Deer in the area. I have seen ticks in my backyard before and have had one on me before. I haven't noticed any bites or rash but thought there may be a possibility since everything i see online about sounds similar. It's been 6 months so far and the frustration and stress of not knowing is killing me. Thank You, XXXXXXX
Hi XXXXXXX
I appreciate the narration of the sequence all the events and details of the illness that took place since Nov 2011.
Let me assure you first that, you should not be worried about the small drop and rise in platelet count. The small variations can be normal as far as the count is stabilized at 0000/dl. So your stressful thoughts can mean a lot on your overall health. I assure you that you are not battling life with a low platelet count. I have seen patients doing well at 20,000/dl.
Yes you should be concerned about a sudden drop in the platelets. Hence you should not acquire any new infection which can deplete the count further.
Second suggestion, if you have suspicion of Lyme disease it first needs to be ruled out with a blood test. If you had Lyme's earlier which could have been cleared with the use of antibiotic your blood shows positive for IgG antibodies. Your Family physician should know about such suspicion and immediate objective evidence is to be obtained.
Third suggestion, the hematologist should be competent or final authority to rule out any thing serious out of the low platelet. You are doubly sure now after a normal Rheumatologist. Anti nuclear Antibodies are present in many autoimmune diseases. Though unsure a Rheumatologist may find a reason for the low platelets be it an autoimmune disease. Autoimmune disease can be a good reason for fatigue and loss of energy. I am not sure how would the treatment plan go if anything is proved. Sometime an infectious agent (a gut infection in Nov 2011) can trigger antibodies against your own cells.
Till then Vitamin D supplementation can be given by your treating physician. Some natural vitamin and minerals may be added. I do not think you need any other treatment till you are proven with any condition. Please do not take medicines for any condition ( antibiotics, steroids etc) till anything is proved.
Hope this answer can throw some light.
Regards
I appreciate the narration of the sequence all the events and details of the illness that took place since Nov 2011.
Let me assure you first that, you should not be worried about the small drop and rise in platelet count. The small variations can be normal as far as the count is stabilized at 0000/dl. So your stressful thoughts can mean a lot on your overall health. I assure you that you are not battling life with a low platelet count. I have seen patients doing well at 20,000/dl.
Yes you should be concerned about a sudden drop in the platelets. Hence you should not acquire any new infection which can deplete the count further.
Second suggestion, if you have suspicion of Lyme disease it first needs to be ruled out with a blood test. If you had Lyme's earlier which could have been cleared with the use of antibiotic your blood shows positive for IgG antibodies. Your Family physician should know about such suspicion and immediate objective evidence is to be obtained.
Third suggestion, the hematologist should be competent or final authority to rule out any thing serious out of the low platelet. You are doubly sure now after a normal Rheumatologist. Anti nuclear Antibodies are present in many autoimmune diseases. Though unsure a Rheumatologist may find a reason for the low platelets be it an autoimmune disease. Autoimmune disease can be a good reason for fatigue and loss of energy. I am not sure how would the treatment plan go if anything is proved. Sometime an infectious agent (a gut infection in Nov 2011) can trigger antibodies against your own cells.
Till then Vitamin D supplementation can be given by your treating physician. Some natural vitamin and minerals may be added. I do not think you need any other treatment till you are proven with any condition. Please do not take medicines for any condition ( antibiotics, steroids etc) till anything is proved.
Hope this answer can throw some light.
Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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