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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Green Stools, Vomiting, Rectal Bleeding. Family History Of HNPCC Lynch Syndrome

My 9 year old daughter started with bloody neon green diarrhea & vomiting starting at 2am-4am sporadically for the past two years. (Incidentally, she started car sick, if not seated in the front, when she was about 4 & will vomit. She also had a case of severe rectal bleeding & vomiting that the hospital told us was definitely food poisoning . That incident started at 3am also & it was about the time this all started 2 years ago. Her pediatrician was upset they didn t test her stool samples. About a month ago this has been consistently every night at 3am & was sent to a pediatric GI. She had a CT scan that showed inflammation & increased nodes in her right mesentery next to her cecum & a small cyst bilaterally in her ovaries. They did a colonoscopy & EGD. The colonoscopy report showed diffuse mild nodules in her colon. The GI did biopsies throughout & thank God they came back normal. My family has HNPCC Lynch Syndrome 2 (MSH2 mismatch repair gene). I don t understand what causes nodules throughout a 9 year olds colon? Could you please explain this to me? And why are all her BM w bright green sometimes neon green & it always starts at around 3am & can last a couple of hours. It is also causing severe cramping & she moans while sleeping. They had me collect stools for a week & they came back negative & no food allergies . The Promethius test came back negative for IBD , Crohn s, & Colitis. Her ANA s started slightly elevated at 1:40 & in the last week they are now positive at 1:80. Her SED rate was elevated to 14 when they did the CT scan, but are now in normal range, but this continues on. I got diagnosed w/ severe CNS Lupus w/brain lesions & positive Obands that have increased in numbers on spinal taps along w/elevated proteins . They thought I had MS & still aren t sure, but I went through a year of IV Cytoxan & take plaquenil & Imuran daily. I also have APS (Hughes Syndrome). Also, as crazy as this sounds, my husband had a ruptured aneurysm at 24 years old that luckily bleed out at his jejunum caused by an AVM. He flatlined more than once & he was the first person coiled & sprayed w/that glue type med on a ruptured aortic aneurysm. They told him to go about life as usual, but it reruptured a month later, almost causing me to lose him again as his hemoglobin stayed around 1.5-3. it took 4 IV s to keep blood pumping into him & the bed tilted backwards, before they could give him surgery. His hemoglobin was too low to do a resectioning for a few days, before they had no choice but to go in & fix it. He is very lucky to have been at a trauma teaching hospital? Before we tried getting pregnant & had 3 miscarriages, they told us not to worry about passing the AVM along to a child, but the research came out after we had her that they can be hereditary. They told us his was just a freak genetic malformation. Any ideas what to do next? They are referring us to a geneticist, but the one that tested my family will not test her for HNPCC or AVM s b/c she is a minor. I have no siblings & lost my mother to cancer at 61 years old, but my 1st cousin got her colon cancer at 27. all children in our family are to start having colonoscopies at 17 years old. Do you know of any centers that will test her as a minor? I live in FL & was treated for a year & a half every 6 months by Mayo Clinic in MN, & my doctors followed their orders. I have a neuroimmunologist there & they are stumped on what my exact dx is. The best they could come up w/was CNS Lupus & APS w/possible MS. I haven t had any new active lesions since the Cytoxan & was very allergic to MS injectables. However, my ANA s & Anti-DS-DNA s have yet to lower. They say my neuropathy all over my body & short term memory loss is caused by the damage in my frontal lobe & have also labeled me w/fibromyalgia. Thank you for your time.
Mon, 8 Oct 2012
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Pediatrician, Neonatology 's  Response
Hi,green stools can be the result of many causes like oralmingestion of iron or iron rich food,green eafy vegetables,too rapid transit of food in the intestihe and hence bile stainig remaining in the stool,etc.whereas in your child with all the history gven by you in detail and very nicely ,we have to exclude other causes also.you are fortunte that you are in a place where all comprehensive invstigations can be done and are being done! As the biopsy now is normal why not wait and watch!I pray God to give you the patience and energy to endure the wait.Wishing all the best to you and your family
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Child Has Green Stools, Vomiting, Rectal Bleeding. Family History Of HNPCC Lynch Syndrome

Hi,green stools can be the result of many causes like oralmingestion of iron or iron rich food,green eafy vegetables,too rapid transit of food in the intestihe and hence bile stainig remaining in the stool,etc.whereas in your child with all the history gven by you in detail and very nicely ,we have to exclude other causes also.you are fortunte that you are in a place where all comprehensive invstigations can be done and are being done! As the biopsy now is normal why not wait and watch!I pray God to give you the patience and energy to endure the wait.Wishing all the best to you and your family