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Feeling pressure in chest and shortness of breath. Showing mild gastritis. Having fatigue and discomfort in abdominal cavity. Suggestions?

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Practicing since : 2007
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I am beginning to experience onset of symptoms I experienced several months ago. About 3 1/2 months ago I was feeling pressure in my chest and shortness of breath. I went to the ER and ruled out cardiac issues. Two days later the pain morphed and mutated, with pressure still in the chest area, but increasing pain under the rib cage. The pain became debilitating and knocked me to the floor - unable to call for help for several minutes. When I called for help, my doctor sent me for an abdominal ultrasound and cardiac monitor. Those tests revealed nothing, but hours later I again was in excruciating pain and wound up in the ER. I was in the hospital for several days and had a plethora of tests run (Xrays of chest and abdomen, EKG, MRI, CAT scan, Echo cardiogram, endoscopy....everything short of a cardiac catharitization.) Nothing showed up except very mild gastritis. The only other thing that showed was slightly elevated liver enzymes - 4 times the normal limit. They were not overly concerned at that point, stating that they don't become really concerned until it is at least 10 times higher. I was discharged with a prescription of pantoprozanole and told that my symptoms most likely were viral related. I went for a follow up with my primary 10 days later, feeling good but EXTREMELY tired. He thought it was normal viral rebound and drew blood. The blood work revealed extremely elevated liver enzymes (1600 and 2200). I went to see the gastroenterologist who continued to follow me until the symptoms became very severe again. They admitted me again, did several tests including a liver biopsy, and discharged me with some pain medication. The liver biopsy revealed S2 fibrosis and some iron deposits. Subsequent blood tests showed my liver panels returning to normal. They ruled out all forms of hepatitis, hemochromatosis and all that was left on the table as a possible diagnosis is an autoimmune disorder. For the last couple of months my symptoms have come and gone, mostly gone. And my last liver panel 3 days ago was completely normal and I was asymptomatic. However, in the last couple of days since seeing the doctor my symptoms are returning - fatigue, tightness in the chest, discomfort in the upper abdominal cavity especially with sitting or bending, shallow breathing. I don't know if this is from the doctors pushing on the liver area during the last exam or if it is coincidental. Any thoughts would be greatly appreciated.
Posted Sun, 7 Jul 2013 in General Health
Answered by Dr. Imraan Hussain 2 hours later

Thanks for your query.

I can feel your concerns.

Feel sorry to read all your history , however good thing is that no cardiac or pulmonary issues were there.

Autoimmune liver disease not presents alone , its a systemic disease and some other autoimmune processes are going along with it.

Those include hemolytic process, thyroid disorder, pernicious anaemia, arthritis, adrenal gland problems and fatigue.

Lupus is a slowly evolving disease and its not necessary that all the investigations are positive at a time and it needs follow up.

My recommendations are that you should be worked up for autoimmune diseases .

Continue with rest of medications.

Hope I answered. if you have any other query ,I would be honored to reply.


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