Suggest Treatment For Joints And Muscle Pain Along With Asthma And Urticaria

Posted on Mon, 15 Feb 2016

Question: Hi, my daughter has an array of crazy symptoms and we have been trying to diagnose her condition. we have seen a few specialists but nothing has been determined. We are awaiting an appointment at Children's Hospital of XXXXXXX She has Asthma, Allergies and Cold Urticaria (main problems) In addition she has the following strange things: Chronic Sinusitis, Blue hands that last for days, she had blueness on her chest last night, Joint and Muscle Pains (mainly on one side of body like knees and arm, shoulder and neck), Sometimes pains in the chest, could be gas, not sure. Stomache issues like nausea, gas, and hurting after eating, fatigue, migraines. Circle appeared on her inner elbow that was red like eczema but with a blue lining around it, low blood pressure drops at times which has caused her to faint (but that was a couple of years back). We had tons of blood work done, a marker came up for Scleroderma but he would not diagnose the disease saying lack of symptoms. Any clue as to what we may be dealing with?

Answered by Dr. Dr. Shruti Rijhwani (5 hours later)

Brief Answer:
Seems to be autoimmune disorder.

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well looking into your problem I would like to tell you that , asthma , allergies and urticaria they almost fall in same category which you can see as an extended spectrum of disease . People who have urticaria are prone to angioedema also which can give rise to her stomach complaints like bloating and hurting after eating . I would like to see her ANA , ENA profile , C1Q Esterase levels , complement levels C3 and C4 , COOMBS test , Urine r/m . She may be having underlying Lupus as she also has Raynauds phenomenon . All these autoimmune disease are evolving and frequently change categories as they progress so it will difficult to label her just on the basis of symptoms .

Dr. Shruti

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

Follow up: Dr. Dr. Shruti Rijhwani (36 hours later)

Hi Dr. Rijhwani,
I've uploaded XXXX blood work for you to review. Just looking at another opinion.
Thank you for your response.
Mrs. XXXX

Answered by Dr. Dr. Shruti Rijhwani (19 hours later)

Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for reverting back.

I have seen the blood reports and yes she has been extensively evaluated . Her Vitamin D is low . Her autoimmune markers are normal and eosinophils are high probably because of urticaria and allergic tendencies . Her Scl 70 is positive which may just indicate that she may have develop scleroderma in future but at present there are no symptoms except for blue hands in winters . I think we should go conservative and carefully observe the patient because treatment is not justified until we have solid evidence or developing symptoms .

Dr. Shruti

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. Vaishalee Punj