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Suggest Treatment For Recurrent Kidney Infections
Question: Hi i have been ill since returning home to XXXXXXX from a trip to new york. I landed home 28 april 2014 and 2 days later was treared with antibiotics for bladder infection. I felt i wasnt fully recovered and i was the treated for a kidney infection with more antibiotics. 5 weeks later i was very sick and sent to hospital who sent me home. Bloods fine, chest xray - fine. Lots of different bacteria in urine. 3 weeks later my doctor treated me for pylonephritis. Ultrasound - fine. Head mri- fine. Cystoscopy - fine. Gastrosopy- fine. Bloods showing i have autoimmune disease but doctors dont seem to be be able to find it. Liver reading was high. Came off crestor and liver readings dropping? Im still very fatigued and a dizzy. I would be glad to hear your opinion. XXXXXXX
Brief Answer:
Needs autoimmune workup for specifying diagnosis
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Recurrent kidney infections with antibiotics and normal rest of the work up except autoimmune profile makes it an autoimmune cause. Now what autoimmune specifically? that is going to be answered by extensive rheumatological work up for assays for different antibodies like ANA, Anti DS DNA, Anti XXXXXXX anti mitochondrial antibodies etc.
Lupus nephritis may fit the possibility as kidneys are quite often involved but that should give renal functions a jolt and compromise it a little which i can't see in your history.
Liver functions elevate any how in many conditions including autoimmune so not specific in aiding diagnosis.
Nut shell, it needs an extensive work up to reach the diagnosis. You need to hang on and stay in touch with your doctor for further management. I would suggest a rheumatologist.
I hope it helps. stay in touch with your healthcare provider for further guidance as our answers are just for education and counselling purposes and can not be an alternative to actual visit to a doctor.
Take care and dont forget to close the discussion please.
Regards
Khan
Needs autoimmune workup for specifying diagnosis
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Recurrent kidney infections with antibiotics and normal rest of the work up except autoimmune profile makes it an autoimmune cause. Now what autoimmune specifically? that is going to be answered by extensive rheumatological work up for assays for different antibodies like ANA, Anti DS DNA, Anti XXXXXXX anti mitochondrial antibodies etc.
Lupus nephritis may fit the possibility as kidneys are quite often involved but that should give renal functions a jolt and compromise it a little which i can't see in your history.
Liver functions elevate any how in many conditions including autoimmune so not specific in aiding diagnosis.
Nut shell, it needs an extensive work up to reach the diagnosis. You need to hang on and stay in touch with your doctor for further management. I would suggest a rheumatologist.
I hope it helps. stay in touch with your healthcare provider for further guidance as our answers are just for education and counselling purposes and can not be an alternative to actual visit to a doctor.
Take care and dont forget to close the discussion please.
Regards
Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have had a lot of bloods done. 29/07/2014 results areTotal protein- 70. Albumin-41. Bilrubin-4.7. Alkaline phosphatase-83. Gamma-glutamyl transferase- 64. Alt-30. Urea-1.8. Creatinine-56. Tsh-1.17. Free t4-18.4. Urine culture-colony count- no growth.glucose-5.4. Wbc-8.41. Rbc-4.14. Hb-13.5. Pcv-0.404. Mcv-97.4. Mch-32.5. Mchc-33.3. Hdw-1.95. Platelet-310. Neut-6.57. Lymph-1.28. Mono-0.34. Eos-0.07. Baso-0.09. Luc-0.06. Esr-23. Wbc-8.41. Rbc-4.14. Lyme c6 antibody eia- neg. ccp antibodies- neg. ana- positive. Ana titre-6400. Ana pattern- multiple nuclear dots. Anti-dsDNA- neg. anti-SSA/RO-neg. anti-SSB/LA- neg. anti-centromere protein B- neg. anti-jo1- neg. anti-sm- neg. anti-sm/RNP-neg. anti-Ribosomal-P-Protein- neg. anti-Sc170-neg. anti-liver kidney microsome- neg. mitochondrial antibody(AMA) - neg. smooth muscle antibody(SMA)- positve. Cholesterol-4.3. hDL-1.4. LDL-2.4. Triglyceride-1.4. Sodium-137. Potassium-4.2. Calcium-2.26. Phosphate(inorganic)-1.30. Free T4-14.3. HepatitisA Igm- neg. Hepititis BsAg - neg. serum iron-19.2. Transferrin-2.5. Transferrin saturation(calc)-31. TIBC(calculated)-31. Total protein-68. Albumin-38. Immuglobin-G-9.26. Immuglobin-A-1.05. Immuglobin-M-1.03. Biblirubin(total)-6.9. Tsh-1.98. Alpha-1-antitrypsin-1.67. Caeruloplasmin-0.38. Ferririn-68.0. To date thats what i have done. I aslo get injected every 3 months for vit B12.
Brief Answer:
Autoimmune Hepatitis Likely
Detailed Answer:
Thank you for getting back to me!
i read through labs and i can correlate the labs to an autoimmune Hepatitis. Smooth muscle antibodies and ANA are positive with high liver functions all are connecting with each other and pointing significantly to an autoimmune hepatitis disorder.
Dont worry . corticosteroids, either alone or in combination with azathioprine, will help. Just get to a hepatologist or a rheumatologist and let them help you in this regard.
Even if they doubt the diagnosis, there is no harm in putitn gyou on this conservative therapy to see whether you respond to it or not.
I am sure it will. I hope it helps. Lets not get worried with more aggressive options like liver transplant at now and hope for the best.
Take care
Khan
Autoimmune Hepatitis Likely
Detailed Answer:
Thank you for getting back to me!
i read through labs and i can correlate the labs to an autoimmune Hepatitis. Smooth muscle antibodies and ANA are positive with high liver functions all are connecting with each other and pointing significantly to an autoimmune hepatitis disorder.
Dont worry . corticosteroids, either alone or in combination with azathioprine, will help. Just get to a hepatologist or a rheumatologist and let them help you in this regard.
Even if they doubt the diagnosis, there is no harm in putitn gyou on this conservative therapy to see whether you respond to it or not.
I am sure it will. I hope it helps. Lets not get worried with more aggressive options like liver transplant at now and hope for the best.
Take care
Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Really. Gosh. My own doctor didnt seem to think it was hepatitis related!!! But she still doesnt have answers for me. Thank you.
Hi , should i ask for spceific bloods done? Would your recomend other bloods i should get done. Im having bloods done on tuesday and it would be great to have some information to help me along the way. XXXXXXX
Hi , should i ask for spceific bloods done? Would your recomend other bloods i should get done. Im having bloods done on tuesday and it would be great to have some information to help me along the way. XXXXXXX
Brief Answer:
AIH-1 it is. Labs are pointing it,
Detailed Answer:
Thank you for the response!
As i said enough of the blood work up has been done. Its time to start you on corticosteroids and azathioprine on trial basis to see if there is any improvement. Anti microsomal antibodies are very specific for liver and it comes positive only in hepatitis either autoimmune type 1 or a to e hepatitis.
These are some of the tests done to confirm hepatitis autoimmune.
Liver-kidney microsomal type 1 (LKM-1) antibody
Serum protein electrophoresis (SPEP)
anti–liver cytosol 1 (anti-LC1) antibodies
Quantitative immunoglobulins
Urgent liver biopsy to confirm
As they say eyes can not see what the mind does not know. Get a rheumatologist for further guidance and management.
Take care
Khan
AIH-1 it is. Labs are pointing it,
Detailed Answer:
Thank you for the response!
As i said enough of the blood work up has been done. Its time to start you on corticosteroids and azathioprine on trial basis to see if there is any improvement. Anti microsomal antibodies are very specific for liver and it comes positive only in hepatitis either autoimmune type 1 or a to e hepatitis.
These are some of the tests done to confirm hepatitis autoimmune.
Liver-kidney microsomal type 1 (LKM-1) antibody
Serum protein electrophoresis (SPEP)
anti–liver cytosol 1 (anti-LC1) antibodies
Quantitative immunoglobulins
Urgent liver biopsy to confirm
As they say eyes can not see what the mind does not know. Get a rheumatologist for further guidance and management.
Take care
Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I will see doctor on tuesday. XXXXXXX
Brief Answer:
:)
Detailed Answer:
You Are welcome XXXXXXX
Take care
Khan
:)
Detailed Answer:
You Are welcome XXXXXXX
Take care
Khan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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