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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child has recurring illness, severe hair fall, hives breakout, shortness of breath. Autoimmune disorders ruled out. Suggestion?

I have a six year old daughter who has had some illness off and on since two. When she was two she ran a fever for over 2 months off and on. All of her hair fell out and she would break out in palm size hives . Her gums would swell so much that her front teeth would seperate. there were allergy tests that revealed only week allergies to ash trees(Which we do not have around). she lost 7 pounds which was 33% of her body weight. Symptoms resolved....and we moved forward. Last winter she began to complain of loosing her breath , there was not any identifiable shortness of breath or dyspnea noted, but she did begin to fatigue easily and quickly. She had a fever of 100-102 degrees for two weeks. One evening I finially took her to the ER and after much arguing with the PA she did a mono spot which came back positive. She had several months (Spring and Summer) that she felt well. She is not running the fevers again and becomming fatigued easily and is begining to loose weight. Auto immune disorders were ruled out. Any suggestions?
Thu, 25 Oct 2012
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Pediatrician 's  Response
Hi

We need more details to help you.
What were the investigations done and their findings at the age of 2? Its unlikely for allergy alone... as loss of hair and weight loss are not seen in allergies.
The last winter episode looks like hyper reactive airway disease. What was done for that?

What are the present problems other than fatigue and loss of weight?
What is her present weight and height? How is her mentation? Any family history of significant illnesses? what is her complete blood count- Hemoglobin, white cell count, Platelets, ESR, Peripheral smear?
Where there any significant findings on examination like liver or spleen enlargement or lymphnode enlargement?
How is her food intake?
Have you checked her thyroid profile any time?
The three episodes may or may not be related. But she needs a proper evaluation- detailed analysis of history, detailed physical examination and investigations as needed.
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