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doctor bhaskaaran

doctor bhaskaaran

wkfvcepdupscibtlbsbo, http://www.lmyhjkaety.com iaroburchp

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Provisional Diagnosis-Rheumatoid Arthritis?SICCA syndrome IGT Subclinical Hypothyroidism Hyperuricemia
Final Diagnosis-Rheumatoid Arthritis Sjogren's syndrome(MCTD) IGT Subclinical Hypothyroidism
History and Findings-A k/c/o Rheumatoid Arthritis 10yrs on Ayurvedic Rx h/o Polyarthritis B/l symetrical big & small joints/dry eyes & dry mouth
Investigation-HbA1c-6.9%,ANA +ve (16.54),RAF +ve (512),uric acid-6.5,CRP-3.60,ds DNA-8 (neg),Serum.Protein EP-No M band,TSH-7.02,ESR-56,Hb-12.5,C3 C4-normal,ANA profile SS-B +++,SS-A +++,RO 52 +++ Eye test-Schirmer's +ve fit for HCQS
Treatment-HCQS,Zyloric,Azoran+LT4
Follow Up-

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Provisional Diagnosis-T2DM/SHTN/D,Nephropathy/CRF/Lichen Amyloidosis legs ? Multiple Myeloma ?Amyloidosis AL
Final Diagnosis-T2DM/SHTN/D.Nephropathy/CRF/AL Amyloidosis
History and Findings-Treatment from Nephrology Dept Lake shore hospital A k/c/o T2DM/SHTN/D.Nephropathy/CRF last 3yrs Rise in creatinine steadily since 8months,persistent anemia reported to AIMS 0n 22/08/11
Investigation-ESR-122,Hb-8.6,Albumin-3+,blood urea-119,Creatinine-6.9,Calcium-7.7,Phosphorous-5mg,ALP-148,GGT-29,A/g-3.7/4.56,PSA-5.10,CRP-14.7,ECG-LVH,CXR-Cardiomegaly LV S.IgG-2380,Beta 2 Microglobulin-15.6,kappa,Lambda ratio-2.05,BM aspiration 1/09/11-normal study,BM biopsy 1/09/11- Cellular marrow with trilineage maturation,anterior abd wall fat pad biopsy 14/09/11-Report 17/9/11 PAS weak staining for eosinophilic material in the congo red shows apple green bireferingence with polarising light consistent with Amyloidosis Case referred to Medical oncology
Treatment-Thalidomide with Dexamethasone started 20/09/11
Follow Up-

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