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Child has weakness, stomach pain, diarrhea, headache, fever. Family history of chronic MDS. Any connection?

I have a 14 year-old daughter who is sick very often (approximately once every 3 weeks or so), usually with very similar symptoms of extreme weakness, GI symptoms such as stomach pain, acute diharrea, headache and high fever. Each episode lasts approximately 3-4 days and then she recovers. As a small child, from the age of 1-5 she suffered from severe abdominal pain that would literally incapacitate her for between 6 and 12 hours at a time; her abdomen would actually physically swell up and become hard to the touch, almost like a pregnant stomach. At the time, we tried ruling out all kinds of food allergies and even did an upper endoscopy when she was 5 that revealed nothing. Eventually, the symptoms disappeared for several years. The new episodes of frequent illness as referred to in the beginning of my note, began approximately 2 years ago. The physical abdominal symptoms have not reappeared. Her latest blood results reveal the following abnormal levels: High LDH = 466 (ULN = 440) High Fibrinogen = 464 (ULN = 400) High ESR = 25 (ULN = 20) High monocytes = 21.8% (ULN = 13%) One thing that her pedatrician and I are exploring is the possiblity of FMF as my daughter s father is of Tunisian origin. I, however am American from a family originally of Slavic and/or Eastern European origin and we are also not aware of anyone in my husband s family who suffers from FMF or anything similar to it. My daughter s grandmother has recently been diagnosed with chronic MDS...could there be any connection there? I would appreciate your thoughts and ideas for next steps in exploring this. Thank you, Debra
Asked On : Thu, 21 Feb 2013
Answers:  1 Views:  54
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Pediatrician, Neonatology 's  Response
i would like to know her weight gain pattern. abdominal tuberculosis,porphyrias to be ruled out. i would suggest serum electrolytes, mantoux, urine for porphyrin examinations. if weight gain is poor, work up for immunodeficiency to be considered.
Answered: Fri, 22 Feb 2013
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