At first, this man thought he had food poisoning. It turned
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Dr. Binal Doshi
At first, this man thought he had food poisoning. It turned out to be something far worse.
Jeffrey Sank, 43 years old, always knew when he was going to have an attack: Its onset was signaled by the same kind of uneasy, “uh-oh” feeling that portends an impending cold. But Sank’s problem wasn’t in his head - it was in his gut. And when he felt the initial abdominal pangs, he knew that he had about 12 hours before he was miserable, or at worst incapacitated, for the next day or two. At first the attacks were intermittent. But after several months the pain, centered in the right upper quadrant where the liver and gallbladder are located, increased in severity and frequency. Sank had also discovered that during the episodes he ran a low-grade fever - less than 101 degrees - which suggested a possible infection.

Clue 1: He didn’t have cancer

Clue 2: Gallstones were not present

Clue 3: A CT scan just after an attack showed nothing abnormal

Clue 4: Blood test revealed that his level of C-reactive protein, which measures inflammation, was sky-high at 148 mg/liter

Clue 5: Tests ruled out malaria as well as porphyria, an inherited disorder that can cause abdominal pain

Clue 6 : No sign of adhesions, a form of scar tissue that can cause recurrent pain

Clue 7: Tests ruled out pancreatitis, a perforated ulcer and a rare hereditary disorder called angioedema.

Can you find out the cause?
S●●●●●i M●●●●l and 11 others like this
Like
Comment
Share
Dr. P●●●●●●H K●●●R
Dr. P●●●●●●H K●●●R Internal Medicine
Possible that a worm can cause this kind of picture..
Mar 17, 2017Like
Dr. B●●●l D●●●i
Dr. B●●●l D●●●i General Medicine
Hey all, it is actually quite a rare cause. It is an inherited genetic disorder. Any ideas?
Mar 17, 2017Like
Dr. B●●●l D●●●i
Dr. B●●●l D●●●i General Medicine
Familial Mediterranean fever (FMF), a common inherited disorder was the culprit. Sank was 38 and had no history of a rash or achy joints, nor did he have a family history. He was descended from Eastern European, or Ashkenazi, Jews who settled in Austria. His infectious-disease specialist considered FMF but did not pursue it after Sank told him he was of European descent. Sank underwent a genetic test that confirmed the diagnosis of FMF and revealed that he had inherited mutated copies of the affected gene from both parents. Doctors gave Sank a course of colchicine, a well-tolerated drug most commonly used to treat gout. Colchicine is also a mainstay therapy for FMF. The drug had a dramatic effect. After Sank began taking it, his attacks largely ceased.... Read more
Mar 17, 2017Like