Patient complains of pain in the joints Doctors puzzles long, and are then surprised

The heart of the man a rest. His body is at a temperature of 37.7 degrees Celsius. Knees and shoulders pain when moved. For the Doctors at Massachusetts General Hospital in Boston (United States) is a mystery, what is wrong with the African-derived patients. For months, the 44-Year-old with painful torments the joints. Shoulders, knees, fingers, everything hurts him. The doctors are stumped. Just by chance, the Doctors in Boston, finally, the solution to the puzzle.

Patient loses 18 kilos in ten months – involuntary

What the man experienced previously, is a martyrdom. First, he introduces himself with a rheumatologist. The examined him and injected shoulders, an anti-inflammatory medication in the pain. Without Success. On The Contrary. With pain in knees and finger joints of 18 years, emerges before from Africa to the USA wandered man to back to the rheumatologist. Tapping the syringe to a fibromyalgia, is hunting again in the shoulder of the patient, and sends him with a painkiller prescription home. However, the condition of the man is worse.

Because his belly hurts, he eats hardly. The pain in the chest are unlikely to endure – especially when he lies on his back. He sleeps little, and badly. Often he is exhausted even to rise from the bed. In the “New England Journal of Medicine” (NEJM) published a case report of Sheila Arvikar, and your Team is that he loses within ten months – involuntarily – around 18 kilogram of body weight.

Influenza, HIV, Borrelia: Doctors puzzle more

His sister brings him to the emergency room. There the Doctors-in socket according to a blood test. The man has far too little white blood cells. Take a look at the thing more accurately and quickly find a pulmonary oedema, an accumulation of fluid. To do this, you will discover on an x-Ray of fluid between the lungs and the Ribs and close the outpouring of a so-called pleural. How do the joints come pain, however, remains a mystery.

Tests on influenza viruses, HIV, and Borrelia bring no information. Then a glimmer of hope. The man is wearing, apparently, cytomegalo viruses. A Test confirmed that. This species is from the family of herpes viruses affects human salivary gland cells and the white blood cells. Dangerous – especially for people with a weakened immune system. And the Odyssey for the enigmatic patients continues.

Because when the Doctors take his heart and once more under the magnifying glass, you will see that also in the pericardial fluid has accumulated, which do not belong there. This so-called pericardial effusion can be life-threatening because the heart of a certain amount of fill sufficiently with blood, and the body with enough oxygen supply. The heart specialists have to answer. The man is laid in the cardiology. The next day his temperature climbs above 39 degrees Celsius.

Tuberculosis? Cancer? The search goes on

More than half a Liter of liquid, the medical team sucks in Boston from the ooded pericardium. But what has caused the pericardial effusion? Tuberculosis, cancer, perhaps an auto-immune disease? For tuberculosis, the fever and the unwanted drama talk tables weight loss. In contrast, a Test of speaking – also the course of the disease does not fit into the picture. Will smash soon the presumption that the Patient is suffering from a cancer disease. Of a Tumor, not a trace. The Test on cancer cells is negative.

Again, the Doctors rheumatism, to bring disorders into the game. However, as you rotate it and apply the low values of leukocytes to fit neither to diseases of rheumatoid Arthritis, and other rheumatic. Finally, the so-called Lupus erythematosus device, also known as a butterfly braid, to the attention of the physician. A rare autoimmune disease, which occurs in 90 percent of cases in women and perhaps that is why so long has not been suspected to be the pain in the man the cause. But suddenly all the pieces of the puzzle fit together. Joint pain, fever, decreased number of white blood cells, and the pericardial effusion. A Test confirmed the diagnosis.

The Patient continues preparations on his own authority

A Happy End to the medical ascent and descent for the patient has not, by the way. First of all, it goes to him, thanks to two medications, the the car to counteract immune disease, significantly better. Later, he relies on his own authority one of the preparations – in the other he lowers the dose. According to “NEJM”, he lives some years with the disease, the remains are in most cases life-long and needs to be treated. One day he is again with severe chest and joint pain in the emergency room.

Source: “the New England Journal of Medicine”