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Bri Saichithra.M,33yrs/F 28/06/10

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Provisional Diagnosis-IgE mediated food allergy Chr fatigue syndrome to r/o Addison's
Final Diagnosis-Chr fatigue syndrome IgE mediated food allergy
History and Findings-H/o Tiredness,lack of allergy,sleepiness during day time especially after food.Occasional feverishness,brachialgia,Gen.oedema picture,paroxysmal palpitation since 1yr DOE class II x 1month.H/o Lt Cervical rib on physiotherapy,TMT,Echo AIMS cardiology 03/06/10-N study,Chikun gunya July 2009.Ayurvedic Rx for all complaints for 5months from Jan-June 2010 O/e Wt-50kg,BP-100/80 lying,90/80 standing.
Investigation-Prior inv in AIMS;FT4-1.15,TSH-2.97(1/06/10) Dec 2009-RBS-97.2,urea-11.6,creat-0.8,LFT-n,Na-137,K-4.3,Ca-8.7,P-3.7,TSH-3.89,CRP-2.03,ESR-38,Hb-12.6,Cxr-N study Present inv:Hb-12.1,ESR-28,RP-1.79,ASO <200,RA-Neg,Corrected ca-9.09,Cortisol-7mcg,Post synacthen cortisol-23.7mcg,ANA-0.25,TG IgA- <0.2 neg,Stool fat ++,OB-Neg,stool chymotripsin-13.6,C1 esterase(C1-INH)-17mg N 11-26,OGD scopy 2/07/10-LA-A esophagitis,deep D2 biopsy,colonoscopy-Normal,ileal biopsy.Both HPR-N study,no e/o dysplasia,granuloma,malignancy,malabsorbtion.IgE-845.2 Pulmo food allergy done
Treatment-Diet chart avoiding knowm allergens Cap.Doxepin 25mg 0-0-1 x 3wks & then 1-0-1 x to ct Tab.Allegra 120mg 1-0-1,Tab.Rantac 150mg 1-0-1 Ensure 2 tsp bd x 3months R/w after 3 months
Follow Up-Pt improving well,no more sedation during day time,energetic,able to attend duties normally,no more angioedema,BP improved 130/80 both lying & standing 27/07/11-IgE-440.9,stool fat-Neg
doctor bhaskaaran

doctor bhaskaaran

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