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Chronic headache, body pain, low WBC and RBC, sore throats, bone marrow biopsy negative. Cause?

My daughter is 17, for the past 3 months has had chronic headache, back pain, chest pain, hip pain, other random body pain, low WBC and RBC , frequent sore throats. Seen a hematologist and bone marrow biopsy negative. Saw a neurologist and infectious disease and bunch of tests negative. Going to rheumatologist on thurs, any ideas??
Tue, 19 Jun 2012
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General & Family Physician 's  Response
Hello there,
I feel instead of seeing so many -ologists and subjecting your daughter to numerous tests, it would be better if you could find the root cause of why she feels this way. A rheumatologist seems like a good option in view of multiple joint pains, but if nothing is diagnosed , I think it would be wise to visit a psychiatrist.

She could be having medically unexplained physical symptoms(MUPS) or a somatization disorder.The only thing that doesnt fit in is the low RBC and WBC.How low is it ?

Is anything worrying your daughter? Do you think she suffers from depression or anxiety?
Hope I have answered your question. I will be happy to answer any further queries you might have.

Have a nice day,

Dr.Divya Kuttikrishnan
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General & Family Physician Dr. Divya Kuttikrishnan's  Response
Hi Cindy,

Thanks for the reply.Sorry for the delay in replying as I hadn't checked my mail for the past two days.

Most of the counts you mentioned are not drastically low ,but yes they are slightly low.One of the reasons for this could be the sequelae of ? viral infection she had with vomiting and diarrhoea.When was her blood counts done?Was it the same time she had the stomach virus or was it at a later date.Other than IV fluids what medication were given at the time?
Any history of gastritis,belching,burping, bloating sensation,upper abdominal pain. If yes, she could be having an H.pylori infection in the stomach.

Another possibility is Thyroid disorders.Has she been evaluated for the same?Thyroid disorders can also present with multiple pains sometimes.

Anyway keep the appointment with the psychologist/psychiatrist on 27th. Probably that will make your daughter feel better. Maybe this(multiple pains, burning sensation)is your daughter's way of dealing with the stress she has with some personal issues.

Meanwhile, I would suggest you enroll her for yoga classes, if there are good yoga instructors in your area.Maybe you can join too. Yoga focusses mainly on the breathing techniques and is good for the overall well being of the mind and body.

Also, keep her happy.A happy mind has a healthy body.Let her continue to do activities which interest her.Spend more time with her, Talk to her.

Please get back to me if you have any further queries.

Wishing your daughter a speedy recovery.

Have a great day.

Dr.Divya Kuttikrishnan
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General & Family Physician Dr. Shanthi.E's  Response
Hi Cindy,

I suspect a case of autoimmune disease here affecting multiple joints and throat.

You have made a wise decision to consult the Rheumatologist. You must go ahead and get an array of tests for autoimmune diseases like SLE, RA, Ankylosing spondyltitis, etc.

Wish your daughter a speedy recovery.

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Sexologist Dr. Saatiish Jhuntrraa's  Response
is there fever ? kindly repeat the counts from some other lab!

Best of luck
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