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What Causes Left Lower Abdominal Pain, Slight Fatty Liver And Depression?

Posted on Thu, 19 Mar 2015

Question: Son is sick and doesn't feel well at all. Left lower abdominal pain. CT scan with oral and iv contrast results were normal other than slight fatty liver. His recent blood tests are normal. His prior blood test did show elevated steroids. He was admitted back in Sep for hypokalemic paralysis. He had a nose infection that took a very long time to heal. He is sensitive to light and sound. Tired ALL the time. Has trouble sleeping.
He does have depression and occasionally anxiety. The abdominal pain is the main concern right now. It is keeping him from being able to do anything.
Any ideas?

Answered by Dr. Binu Parameswaran Pillai (37 minutes later)

Brief Answer:
Cushing's syndrome

Detailed Answer:
Good day,
Noted the history. The elevated cortisol levels, stretch marks in abdomen and his symptoms are making me suspcious of Cushing's syndrome. Low potassium is a feature of Cushing's syndrome. The hypokalemic paralysis was part of this.

This can also happen after taking steroids. However, in that cae his cortisol levels will be low.

In true Cushing's syndrome, cortisol levels will be high. In his case he need further evaluation by an endocrinologist and that can probably solve his case.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (9 minutes later)

Thank you. Would this cause stomach pain?

Answered by Dr. Binu Parameswaran Pillai (1 minute later)

Brief Answer:
Possible

Detailed Answer:
It can rarely cause stomach pain too. Cushings can also cause kidney stones which is another cause of stomach pain.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (6 minutes later)

Would kidney stones show up in the CT scan?

Answered by Dr. Binu Parameswaran Pillai (3 minutes later)

Brief Answer:
Yes.

Detailed Answer:
Good question. Yes it would show up in a CT scan provided the radiologist looked carefully.
. I just mentioned one of the causes of abdominal pain in Cushings syndrome. It can also cause intestinal dilatation which again cause stomach pain.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (1 minute later)

Thank you

Answered by Dr. Binu Parameswaran Pillai (2 minutes later)

Brief Answer:
Expert endocrinology evaluation

Detailed Answer:
He surely requires expert evaluation by an endocrinologist. Many of his symptoms like stretch marks hypokalemia, depression/anxiety and elevated cortisol makes me suspicious of Cushings syndrome.I wish him a speedy recovery.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (11 hours later)

Thank you again.

Answered by Dr. Binu Parameswaran Pillai (19 minutes later)

Brief Answer:
pleasure

Detailed Answer:
You are welcome. Please feel free to ask further if you have any more doubts. If not you may please close the query. You are welcome to reopen the discussion again.
Regards
Binu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar