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Severe abdominal pain with vomiting, pain in feet. Low platelet count with negative hepatitis result. Chances of HIV?

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I'm a 43 yr. old white male from the Chicagoland area. I have been athletic and healthy my whole life until Nov. 20,2011 when something went wrong! A bit of background, I do not smoke or take any drugs.I'm more of a weekend drinker,depending on who i'm out with i may just have a couple drinks or if i'm out watching a game we may go heavier with beer and shots. I'm not taking any medications and i'm the type of person that would barely take an aspirin hardly ever. Here's my story. On Saturday Nov. 20,2011 i went out to dinner with my wife and another couple. I returned home and a few hours later i woke up about 1 am with SEVERE abdominal pain and dry heaving.The pain lasted the whole day and by monday i felt like it might go away.The next day on tues., I took my family to the Bahamas for Thanksgiving and on the night before(on WED) i had another episode. This time along with the severe abdominal that woke me up again around 2am, I was experiencing violent vomiting and diarrhea for hours.I did not notice any blood.Just kept going thru out most the night. The pain lasted the whole day and maybe after 24 hrs. plus started to feel like it was going away again by Fri. Just over 2 weeks later on Mon. Dec.12,2011 i woke up in the early am,maybe 2 am again with the 3rd episode.This time was like the first with SEVERE pain in my abdomen and dry heaving but NO vomit or diarrhea.Just dry heaving. The pain always felt maybe a little to the left of my belly button.I went to the ER that morning and they tested blood,urine and a CT scan. They gave me antibiotic for what appeared to be possible inflammation in the small bowel & pain medicine.The next day I went to see My Family Dr on tues Dec. 13th 2011 where he switched my antibiotics. After i took them for the first time that late afternoon around 4ish i later had black stool, i didn't notice any foul oder. Took the antibiotics again that night around 11pm. went to the bathroom again later that night and still black.On Dec. 21st,2011, I went up to see a GI Dr. for an exam. He noticed from my ER test results that my platelet count was real low 53,000.My abdominal pain was very mild by this point and i haven't had anymore more attacks since the ER visit. Now we were on the search of why my platelets were low. I had more blood test and the platelets went down a little from 53,000 to 50,000.I now went to see a Hematologist about my platelets on Dec. 27th 2011. That Dr. did not feel based off the other test that my liver or spleen were the cause. She also felt the pancreas enzymes looked normal. We did more blood 2 weeks later. At this point i have been off the meds since Christmas Eve and haven't taken anything since XXXXXXX 9th,2012 I went to see My Family Dr. again,this time about my heart cause i was waking up with a racing heart. Maybe cuz' the stress. Only happened in my sleep and would stop racing a minute after waking up.
Took an EKG test and didn't see anything abnormal but did send me to wear a Holter for 24 hrs. to monitor heart activity.Everything with my heart checked out okay. XXXXXXX 11th,2012 wed. The Hematologist called to say the blood looks good but the platelets dropped again for the 3rd test in a row,down to 45,0000 from 50,0000 and the HIV ab1/2 blood test was negative. I looked at a past history of my platelets from 3 yrs. ago and they were at 189,000. XXXXXXX 16th 2012 , I went in for a bone-marrow biopsy.They took Marrow,Bone fragment & Blood. I also went to the lab for more blood work for Hepatitis Test and a Viral Load quantitative RNA test for HIV. Results came back non reactive on all but the platelets remained at 45,000. XXXXXXX 20th 2012 fri. My joints have been sore for sometime and my neck is a little stiff. My left knee which is bad to begin with is making it difficult to walk at times XXXXXXX 30th tues. I went to GI Dr for a scope down my throat. I went to him a year earlier for a colonoscopy due to my father having a small amount of colon cancer. My results were negative and my scope was as well.Feb 15th 2012 my Platelets went up for the first time from 45,000 to 54,000. March 15th 2012 thurs. Platelets up again from 54,000 to 60,000. April 13th 2012 results down from 60,000 to 57,000. Sun April 22nd my hands and feet are starting to tingle and ache.This is still continuing today and has been about a month now.May 15th 2012 tues. I went to see my Family Dr. about the tingling in my hands and feet & He ordered more blood work. I tested Positive XXXXXXX Low Vitamin D (22.3), and platelets slight drop again from 57,000 to 55,000. I went to the Rheumatologist for more blood and urine test. In addition to all the symptoms above, i now noticed what appears to be little red bumps on my tongue and the right side of my jaw was starting to ache a bit.I have a few bumps on the sides of my tongue that started to appear around early XXXXXXX The bottoms of my feet have been causing me some pain for almost 2 months now. My b12 normal,metabolic normal, thyroid normal, Rheumatoid arthritis negative. He did test for Lupus and Lyme disease which came up negative and additional blood work. Which he said all looked pretty good. I have NO skin rash. I do have an uncle that has MS. My platelets have remained low between 30,000 and 60,000, I am very fatigued and taking afternoon naps cause the lack of energy.The bottoms of my feet are still a bit painful and difficult to get out of bed in the morning for about 2 months now.My hands are not as bad but a little joint pain.Sometimes i feel that I have to think about recent events more than usual. My memory at times is a little foggy. Occasionally my neck and back get stiff.
This all started in Nov. of 2011.I'm 43 years old and felt like i was still in my 20's until that one night in Nov. out to dinner. Everything has gone down hill since that night. I'm not sure if something with the food could've triggered something that is the cause of this? It just seems odd that I felt great and 20 yr.'s younger with no medical history at all,then all the sudden i woke up in severe abdominal pain a few hrs after a late dinner at a restaurant. From that point on i went from no history to now carrying a folder full of test files over the past 7 months. Another question,How ACCURATE is HIV test? I had an HIV 1/2 AB screen at 87 days since possible risk that came back NONREACTIVE result. I also took an HIV RNA Quantitive HIV PCR Quant,Log 10 Hiv and the results came back Not Detected. This test was 94 days after possible risk. Are these accurate results? Am i out of the woods with those test? Just to recap, my platelets have been in the 40k-60,000 range. I just tested Positive XXXXXXX 1:1280 and a Vitamin D level at 22.3. Pain in the bottom of both feet lasting 2 months so far,mild ache in both hands,extreme fatigue in the afternoon,mild headaches that come and go only lasting a few minutes,occasional stiff neck.I feel at times i have a little bit of foggy memory where i have to think harder about what i may have done last week.I can remember but it seems to take time to really think about it. I have not noticed any fever or weight difference at all.No loss of appetite.My stomach has been causing a mild belly ache the past 2 weeks that just feels a little off.I go back to see the Rheumatologist this week.It's been 7 months so far and the frustration and stress of not knowing what's wrong is killing me I keep reading about Fibromyalgia. Can that be a cause or is that something that could develop because of something that brought it on? I'm Lost and very scared especially about if there's any HIV possibilities? Thank You, XXXXXXX
Posted Thu, 19 Jul 2012 in HIV and AIDS
Answered by Dr. Aparna Kohli 5 hours later
Thanks for writing in.
I understand your concern but it is extremely unlikely that your complaints are due to HIV. The tests that have been done are extremely accurate. Usually, PCR is almost 100% sensitive at picking up HIV. Since it was negative in your case, you can be absolutely sure its not HIV.
Fibromyalgia usually does not produce the symptoms that you have been having. Also, no food can cause symptoms for such a long while and is definitely not the cause of your symptoms.
The low platelet, abdominal pain, joint pain and a positive XXXXXXX definitely point towards a rheumatological disorder. These disorders are usually due to some antibodies produced by our own body which attack our own cells.
I would like to know if your bone marrow and CT scan results. Please upload the reports using the 'Upload your reports' on the right.
I think a second opinion from another rheumatologist and an empiric trial of low dose steroids may be in order.
Awaiting your reply
Above answer was peer-reviewed by
Follow-up: Severe abdominal pain with vomiting, pain in feet. Low platelet count with negative hepatitis result. Chances of HIV? 8 hours later
Even thou the Hiv ab 1& 2 was done at 87 days from risk and the viral load was a week later at 94 days from risk, Is that still accurate? My other concern is ,could it have been something with the food that night? I felt 20 yrs. younger with never any problems ever ,than all the sudden from that one night out to dinner it hit me in the middle of the night. I remember having a steak dinner and also a lot of tomatoes & onions before the meal. Could any sort of contamination/allergy cause the 3 abdominal episodes? Even thou i didn't vomit until a few days later, i was in severe pain and dry-heaving the first night. What would cause the platelets to drop to below normal around 50,000 when my last test a couple years before were all in the normal range and up around 189,000? I was told the CT scan appeared that there may be a little inflammation in the small bowel and sent off with a prescription. That was back in Dec 2011 at the ER. The Karyotype.I feel like I'm in a downward spiral. Please help. Thank You XXXXXXX
Answered by Dr. Aparna Kohli 1 hour later
Thanks for writing back.
Even though the HIV antibody test is confirmatory if negative at 6 months only, since the PCR was negative, we can be 100% sure that you are HIV free.
As I said, food cannot cause such long standing symptoms. Neither an allergy nor any contamination is responsible for your symptoms.
The cause of the platelet drop can either be a decreased production ( and we dont know how long that had been going on) or an increase in the spleen size or maybe even severe bleeding ( which manifested as dark stools that you had later)
That is why I asked for the bone marrow and CT reports. The bone marrow reports show that there is no reason for a decrease in production. This means there is an increase in the sequestration or there is bleeding.
I am sure that we're definitely looking at some inflammation which could be due to an autoimmune process, as I had explained earlier. You should seriously consider getting a second opinion from a rheumatologist either in your locality or perhaps even on this website.
Let me know if i can address any more concerns
Above answer was peer-reviewed by
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