HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Having Severe Abdominal Pain. Tested Negative For Rheumatoid Arthritis And Lupus. HIV Possibilities?

default
Posted on Mon, 13 Aug 2012
Question: I'm a 43 yr. old white male from Chicago,Il. I have been athletic and healthy my whole life until Nov. 20,2011 when something went wrong! A bit of background, I do not smoke or take any drugs ever.I'm a weekend drinker,depending on who i'm out with i may just have a couple drinks or if i'm out watching a game we may go heavier with beer and shots,sometimes too much. I'm not taking any medications and i'm the type of person that would barely take an aspirin hardly ever. 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 the whole day and by monday i felt like it might go away.The next day on tues., I took my family to the Bahamas for Thanksgiving and on the night before(on 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.I did not notice any blood.Just kept going thru out most the night. The 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 but NO vomit or diarrhea.Just dry heaving. The pain always felt maybe a little to the left of my belly button.I went to the ER that morning and they tested 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 2011 where he switched my antibiotics. After i took them for the first time that late afternoon around 4ish i later had black stool, i didn't 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,2011, I went up to see a GI Dr. for an exam. 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 the ER visit. 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 now 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 ab1/2 blood test was negative. I looked at a past history of my platelets from 3 yrs. ago and 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 quantitative RNA test for HIV. Results came back non reactive on all but the platelets remained at 45,000. XXXXXXX 20th 2012 fri. My joints have been sore for sometime and my neck is a little stiff. My left knee which is bad to begin with is making it difficult to walk at times 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 went to the Rheumatologist for more blood and urine test. In addition to all the symptoms above, i now noticed what appears to be little red bumps on my tongue and the right side of my jaw was starting to ache a bit.I have a few bumps on the sides of my tongue that started to appear around early XXXXXXX The bottoms of my feet have been causing me some pain for almost 2 months now. My b12 normal,metabolic normal, thyroid normal, Rheumatoid arthritis negative. He did test for Lupus and Lyme disease which came up negative and additional blood work. Which he said all looked pretty good. I have NO skin rash. I do have an uncle that has MS. My platelets have remained low between 30,000 and 60,000, I am very fatigued and taking afternoon naps cause the lack of energy.The bottoms of my feet are still a bit painful and difficult to get out of bed in the morning for about 2 months 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. My memory at times is a little foggy. Occasionally my neck and back get stiff.
I'm 43 and felt like i was still in my 20's until that one night in Nov. out to dinner. Everything has gone down hill since that night. I'm not sure if something with the food could've triggered something that is the cause of this? It just seems odd that I felt great and 20 yr.'s younger with no medical history at all,then all the sudden i woke up in severe abdominal pain a few hrs after a late dinner at a restaurant. From that point on i went from no history to now carrying a folder full of test files over the past 7 months. Another question,How ACCURATE is HIV test? I had an HIV 1/2 AB screen at 87 days since possible risk that came back NONREACTIVE result. I also took an HIV RNA Quantitive HIV PCR Quant,Log 10 Hiv and the results came back Not Detected. This test was 94 days after possible risk. Are these ACCURATE results? Am i out of the woods with those test? Just to recap, my platelets have been in the 40k-60,000 range. I just tested Positive XXXXXXX 1:1280 and a Vitamin D level at 22.3. Pain in the bottom of both feet lasting about 3 months so far,mild ache in both hands,extreme fatigue in the afternoon,mild headaches that come and go only lasting a few minutes,occasional stiff neck.I feel at times i have a little bit of foggy memory where i have to think harder about what i may have done last week.I can remember but it seems to take time to really think about it. I have not noticed any fever or weight difference at all.No loss of appetite.No Swollen Lymph Nodes.My stomach has been causing a mild belly ache the past few weeks that just feels a little off.I was retested for my XXXXXXX which this time came back 15.It's been 8 months so far and the frustration and stress of not knowing what's wrong is killing me I keep reading about Fibromyalgia,CFS or H Pylori. Can any of these be a cause or is that something that could develop because of something that brought it on? I'm Lost and very scared especially about if there's any HIV possibilities? Is my test i did at 94 days (since possible risk) accurate to where it can be taken off the list? Thank You, XXXXXX
doctor
Answered by Dr. Divya Agarwal (52 minutes later)
Hi XXXXXX
I do understand your concern.
From the history there is a strong possibility of lupus, since your XXXXXXX is positive, platelets are low, you have had some gastrointestinal bleeding and pain and some cardiac issues. Treatment needs to be started under the supervision of your physician. I think we should be thinking on those lines. Its unlikely to be HIV since the HIV RNA load is negative.
Let me know if you have any more questions.
Regards
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Divya Agarwal (1 hour later)
I've had some test done by 2 different Rheumatologist and they said it doesn't appear to be Lupus according to the results they got.I haven't had or noticed any rash anywhere on my body or face. I've been in the sun a lot this summer which hasn't bothered me at all.So since the HIV 1/2 AB screen at 87 days and the Viral Load at 94 days since risk came back negative,is that result accurate? My current status is platelets are 55,000,Positive XXXXXXX 15,bottoms of feet (mostly in the arch) pain, mild stomach pain for the past month(everyday- on & off),Flatulence that has just made me feel full of air all day,body aches. I still think that it may have something to do with that first night that i got the first episode of sudden Severe Abdominal pain. From that point on,a couple hrs. after that dinner, my whole life went in a downward spiral. The ER said that in the CT scan that it appeared to have inflammation in the small bowel. Is there other things we could be looking for? Thank You
doctor
Answered by Dr. Divya Agarwal (2 hours later)
Hi XXXXXX
Your results for the HIV antibody and the viral load are both negative so that rules out HIV.
The platelet counts are definitely low, from your description it seems like the bone marrow test run on you was normal which indicates that the cause of low platelets is a peripheral destruction of platelets. The spots you mentioned in your mouth could have been caused by them.
The abdominal discomfort you have been facing seems like an inflammation in the bowels, and does not seem to be infective since it is recurring. However since the endoscopy is normal, it rules out inflammatory bowel disease.
To help you further, I would like to know if any other tests were run on you? I would specifically be looking for complement levels, ds DNA and urine routine examination. Did your CT abdomen show any peritoneal fluid or ascites?
Awaiting your reply
Regards
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 659 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Having Severe Abdominal Pain. Tested Negative For Rheumatoid Arthritis And Lupus. HIV Possibilities?

Hi XXXXXX
I do understand your concern.
From the history there is a strong possibility of lupus, since your XXXXXXX is positive, platelets are low, you have had some gastrointestinal bleeding and pain and some cardiac issues. Treatment needs to be started under the supervision of your physician. I think we should be thinking on those lines. Its unlikely to be HIV since the HIV RNA load is negative.
Let me know if you have any more questions.
Regards