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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Stroke. Blood Sugar Level, PPBS, ESR High. Refers To?

My father had a stroke 5 years back (age 56) .He is takinf the following tablets. 1 Aspirin 0-1-0(150mg) 2 Metformin 1-0-1 (500 mg) 3 Phenytoin 1-0-2 (100mg) 4 Phenobarbitone0-0-2(60mg) 5 Envas 0-1-0(5mg) 6Liponorm 0-0-1(10mg) Five months back he started urticaria .neurologist told it is not because of medications because he is taking anticonvulasants, Aspirin and other tabets for long time.They told us to take a dermatologist opinion.Dermatologist gave azythromycin, allegra , and calamin lotionBut he was not responding.We have done blood test and the fasting &PPBS were little high But TSH ,absolute eosinophil count were normal.So dermatologist was telling it is Chronic Ideopathic urticaria.Now he has started giving Broad spectrum antibiotic and atarax.But still the symptoms were not subsiding. Then he started steroids.initially he was responding after that he was not responding to that also.we have done his serum ANA which was in the border line ESR was little high and all other blood parameters were normal .So dermatologist reffered to a neurologist to change phenytoin as well as barbitone.Neurologist told to tapper phenytoin and then Barbitone. He gave leveteracetam, and tappering of phenytoin is going on now. Kindly give your suggestion regarding this case
Mon, 7 Apr 2014
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Internal Medicine Specialist 's  Response
hai. I can c that u have a lot of information to convey but u have missed what is the problem he has now for which u want opinion.
but from ur details I have picked up 2 things:
1) u r from India - bcos liponorm is atorvastatin made by blue cross Pharma
2) that ur father is having generalized itching
kindly perform a serum IgE
if u want more advice I need to know more specific details.
drug like phenytoin and phenobarbitone can produce urticaria but even stopping these drugs is a trial only but no a definite solution since we don't know the cause yet.
but watch out for withdrawal seizures in ur father.
take care.
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Had Stroke. Blood Sugar Level, PPBS, ESR High. Refers To?

hai. I can c that u have a lot of information to convey but u have missed what is the problem he has now for which u want opinion. but from ur details I have picked up 2 things: 1) u r from India - bcos liponorm is atorvastatin made by blue cross Pharma 2) that ur father is having generalized itching kindly perform a serum IgE if u want more advice I need to know more specific details. drug like phenytoin and phenobarbitone can produce urticaria but even stopping these drugs is a trial only but no a definite solution since we don t know the cause yet. but watch out for withdrawal seizures in ur father. take care.