hi how are you?

PROBLEM OF MY CHILD OF LUPUS (SLE)- MR.TILAK FROM INDIA

DEAR SIR,

I AM MR.NILESH TILAK ,LIVING IN A TOWN CALLED PUNE(STATE-MAHARASHTRA- INDIA) MY SON MAST.ATHARVA TILAK (WT- 37 KG.11YRS. BOY) IS HAVING POSITIVE DSDNA (Systemic Lupus Erythematosus--S.L.E.) FOR LAST TWO & HALF YRS.

FOLLOWING IS THE SUMMARY OF HIS PROBLEM-----

FIRST IN APRIL2007 THE PROBLEM START WITH A H/O PROJECTILE VOMITING, PAIN IN ABDOMEN & FEVER OF ONE DAY ON ADDITION HE WAS FOUND TO BE ACUTE PANCREATITIS WITH S.TRIGLYCERIDE UP TO 1285(NORMAL RANGE- 0-200), AMYLASE , LIPASE LEVELS WERE DEFERRED AS BLOOD WAS MILKY. HE WAS KEPT NBM. HAD SIGNIFICANT RTA-220ML OVER 24 HRS, TREATED WITH IV FLUIDS & IV ANTIBIOTIC.
AFTER 24 HRS SOME ORIENTATION IMPROVEMENT. A USG(ABD.) DONE WAS SO. AFTER 36 HRS OF HOSPITALIZATION- ACUTE EXACEBECATION OF ABD. PAIN WITH GUARDING. STARTED ON SOMATOSTATIN UIFUSION. PATIENTS SYMPTOMS IMPROVED WITHIN 12 HRS. O/E- BOWEL SOUNDS WERE ABSENT, HAD PERSISTENT TACHYCAUC BIOCHEMISTRY SHOWED- LIPAEMIC BLOOD, HIGH BSL(122) URINE OUTPUT BEING CONSISTENTLY LOW IN COMPARISON TO INTAKE(IV-BOLUS + FLUIDS)? THIRD SPACE LOSS.
CT(ABD) SHOED ACUTE PANCREATITIS WITH SIGNIFICANT PERIPANCREATIC COLLECTION & B/L PLEMAL EFFUSSION ASCITIS( MINIMAL) THEREAFTER THROUGHOUT HOSPITAL STAY- OCC. FEVER SPIKES, OCC. MILD ABD. PAIN -- SOMATOSTATUI INJUSION GIVEN TOTAL FOR 6 DAYS- ORAL INTAKE STARTED AFTER 8-9 DAYS- GRADUALLY INCREASED TILL TOLERATED. DISCHARGE AFTER 12 DAYS OF HOSPITALISION- ON PANCREAZYMICIN
( THIS ATTACK WAS S/O ACUTED EXACEBECATION OF RECURRENT PANCREATITIS LEADING TO PANCREATIC PSEUDOCYST WITH ASCITIS & PLERUAL EFFUSSION WITH DYSHIPIDEMA & HYPERGLYCEMIA(METABOLIC DERANGEMENTO OR METABOLIC SYNDROME)
AFTER ONE TWO MONTHS OF SERIAL FOLLOW-UPS BY INVESTIGATION SHOWS A DECLINING HB & RAISED AMYLASE BUT AT THAT TIME ACUTE ABD. PAIN REDUCED, IN JULY 2007(TWO & HALF YEARS BACK) HE GOT FIST ATTACK OF AUTO IMMUNE HAEMOLYTIC ANAEMIA (DROP IN HEMOGLOBIN UP TO 4.8d/dl.) WHICH STARTS WITH FEVER AROUND . SO AFTER POSITIVE DSDNA TEST WE CAME TO KNOW THAT HE IS HAVING Systemic Lupus Erythematosus -- SLE.
AT THAT TIME HE WAS ON STEROIDS FOR SIX MONTHS .AS HIS HEMOGLOBIN CAME TO NORMAL 14.8 g/il. SO DOCTOR STOP THE STEROIDS. FOR LAST TWO YEAR HE WAS ON NO MEDICINE & NOT FACING ANY MAJOR PROBLEMS APART FROM MILD PAIN IN JOINTS & SOME TIME HEAD ACEH.

NOW AFTER TWO & HALF YEARS HE GOT SECOND ATTACK (FROM10NOV2009) OF AUTO IMMUNE HAEMOLYTIC ANAEMIA(AIHA) WHICH START FROM FEVER & HEAD ACHE. SO AFTER BLOOD TEST WE FOUND THAT AGAIN DROP IN HB.

FOLLOWING ARE HIS SOME READINGS FROM HIS BLOOD TAKEN ON 24-11-2009 BEFORE STARTING STEROIDS FOR YOUR REFERENCE----

HEMOGLOBIN- 6.4 g/dl

ESR- 117 mm/hr

PLATELET COUNT 164 10^9/I

ANTI DS DNA- POSITIVE TITER 1 (DNA)-- DILUTION 1:20++ ( BY CRITHIDIA LUCILLAE METHOD)

C3 -- 61.3 mg/dl.

ENA SM--- 0.527--- (NEGATIVE) BY ENZYME IMMUNO ASSAY METHOD

LIPASE -- CONVENTIONAL 85 U/I
S.I.--- 85 IU/I

CHEST X- RAY--- NORMAL

ACLA IgG--- POSITIVE

ACLA IgM--- POSITIVE

URINE REPORT- NORMAL

HE IS TAKING FOLLOWING MEDICINES FROM 28NOV2009 WHICH RESULTS STOP OF FEVER & HEAD ACEH --


TAB. OMNACORTIL- 10 MG.-- 5 TAB. A DAY( 2-2-1 )

HYDROXYCHLOROQUNIM SULFATE (200MG.) HCQS-- 1 TAB./DAY

TAB. SHELCAL-500-- 2TAB./DAY

TAB. FOLVITE(5MG)-- 1TAB. /DAY

ECOSPRIN -75MG-- 1TAB/DAY.


CURRENTLY HE IS TREATED BY DR.R.B.KHUBCHANDANI- M.D.(PEDIATRICS)-- SPECIAL INTEREST-- PEDIATRIC RHEUMATOLOGY-- IN MUMBAI- INDIA ( PH NO- +912223865522)

CAN YOU GIVE SOME COMMENTS ON THE ABOVE TREATMENT & SUGGEST US ANY ALTERNATIVE MEDICINE OR TEST TO BE CONDUCTED FOR SAFETY OF MY CHILD? YOU CAN SUGGEST ANY KIND OF DIET ALSO?


YOUR COMMENT FOR THE ABOVE WILL BE VARY VARY HELP FULL FOR US

REGARDS

MR.NILESH V. TILAK

MOBILE NO +919822068763

HOUSE PHONE HO- +912025893391

EMAIL ID- nile5637@yahoo.co.in

info@conexups.com

nile5637@gmail.com



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