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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causing Stomach Bloating,headache And Diagnosed With Erythromalagia?

i was recently diagnosed with advanced microvascular ischemic disease secondary to an MPN (JAK2 positive either ET or PV ... diagnosis seems to go back and forth. BM Biopsy pathologist indicated ET with differential diagnosis of pre-myelofibrosis). MRs of Brain revealed multiple white matter hyperintesities both hemispheres and a larger lacunar infarct in an area affecting executive function. i was also diagnosed with Erythromalagia. i am concerned about possible Cognitive Vascular Disease as i have noticed significant cognitive decline over the last year or so. I am also wondering if i should have diagnostic procedures to see if the small vessel disease has affected other areas of my body or organs or if there are blood clots anywhere in my body. I have persistent headaches, stomach bloating and pain and leg pain (could be bone pain). i am currently being treated for high cholesterol (just after the MRI findings) and also Hydrea. The RBCs have dropped to within range (also had a phlebotomy) but the platelets have gone up since treatment started 3 weeks ago. What other diagnostic procedures would you recommend to identify damage or decreased function in other organs or areas of the body? Thank you so much in advance.
Mon, 30 Nov 2015
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Neurologist 's  Response
You have not mentioned your age and other associated medical problems. The risk factors for ischemic disease need to be evaluated (other than cholesterol level)-
1. serum homocysteine level
2. serum vitamin B12 level
3. ANA, C-ANCA, P-ANCA (to look for vasculitis)
4. hs CRP
5. Apo-A
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What Causing Stomach Bloating,headache And Diagnosed With Erythromalagia?

You have not mentioned your age and other associated medical problems. The risk factors for ischemic disease need to be evaluated (other than cholesterol level)- 1. serum homocysteine level 2. serum vitamin B12 level 3. ANA, C-ANCA, P-ANCA (to look for vasculitis) 4. hs CRP 5. Apo-A