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Diognosed addition desease. Taking Methycobol, hisone. Blood transfusion showed myeloid hyperplasia

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Practicing since : 2002
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Ist normal delivery of female child in XXXXXXX 2003. No problem seen till aug 2007. After that weakness felt and skin dark pigmented and diognosed addition desease in dec 2007 for which hisone tab 20 mg in morning prescribed. All was normal till pregnancy in oct 2008 and hb drop uo to 6.00. 3 and 2 units of blood transfused 2 times in 2 months i.e.april and XXXXXXX 2009 before second delivery (by operation) on 13.06.2009. After that again hb droped in july 2009 than consulted with endocrinologist and he suggested to take a dose of hisone by injecting. this improved hb level and no problem seen till dec 2012 (apprx 3 yrs and 6 months). In last week of dec due to sign of weakness, hb tested and found 5.8 on 28.12.12. On further investigation the endocrinologist and the haematologist suspected that macrocytosis animia may be due to defficiency of B-12 so haematologist advice to take Methycobol inj 500 mg alternate day for 15 days on 05.01.2013 and followed. on XXXXXXX 15, it found necessary to transfued the blood due to breathing problem. so on 15 & 16 XXXXXXX 2013, 3 units transfused and hb found at 10 on 17.01.2013. But it again falling on 28.01.13 to 8.60 than Inj- Methycobol 500 mg with folate tab again suggested and followed for 15 days and hb tested on 12.02.2013 which found 8.2. the haematologist suggested to take bone marrow test which was done befor transfusion of blood in march 2013 and shows MYELOID HYPERPLASIA. On discussion and further investigation made by Dr. XXXXXXX Mathur (Endocrinologist - SMSH, Jaipur) and Dr. XXXXXXX Jasuja (Oncologist - SMSH, jaipur), beta thalassemia trait found. No treatment prescribed except blood tranfusion but unexplained for sudden drop in hb level.
Posted Thu, 16 May 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Anantharaman 46 hours later
Thanks for writing into healthcare magic. Yours is a complicated illness the only consistent feature seems to be anaemia and diagnosed thalassemia trait. I have studied your reports in detail I have some concerns about your diagnosis
1. Do you really have adrenal insufficiency .can you share your reports done at the time of diagnosis. Dark pigmentation is a feature of b12 deficiency and may have confused the diagnosis.
2. Your red cell distribution width is wide suggestive of problems additional to thalassemia trait.if there is documented b12 deficiency it needs to be treated with I.v b12 and folate .i feel that a higher dose of b12 1500 mcg may produce a better response.also an I'm deposit of b12 may produce a better response if given ever weekly once than Iv .you may discuss this with your haematologist
3. Other tests I would suggest would be thyroid function test,anti TPO, anti TIssue transglutaminase antibody to look for other coexistence autoimmunity that can worsen anaemia.

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