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Dr Basu
Dr Basu, Experienced Specialist
Category: Health
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Experience:  MD
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Hi there, My nephew is experiencing some issues that we

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Hi there,

My nephew is experiencing some issues that we haven't been able to pin down with doctors. He is having a significant increase in nose bleeds and vomiting over the past few months. His lab work has just returned and here is some info.

ALT 36
CREATININE 0.2
ANION GAP 20
WBC 4.0
RBC 3.87
NEUTROPHIL 1.1
FERRITIN 10 ng/ml
IRON 94
Platelets 11
Glucose 68

the FERRATIN, CREATININE and WBC seem to be going down over the past few months.

Any help/advice/direction would be much appreciated!

-thom

mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.

mysticdoc :

Your nephew also has low platelet count.

mysticdoc :

Now these results along with abnormal wbc does suggest autoimmune disorder.

mysticdoc :

Antibodies against platelet can destroy them causing frequent nose bleeds.

mysticdoc :

Similarly autoimmune disorder can affect the kidneys as well.

mysticdoc :

Hence, he needs to be seen by a hematologist and a nephrologist.

mysticdoc :

Bone marrow evaluation is required and may be a kidney biopsy as well for proper diagnosis.

Customer:

Thank you very much! I believe he is scheduled for a visit with the hematologist next week. Any thoughts on treatments?

mysticdoc :

This depends on the diagnosis.

mysticdoc :

For autoimmune disorder, high dose steroids, immunoglobulins are commonly used successfully.

Customer:

He has been tested for aids...negative (adopted child)..ok - so that would be a good start then.

mysticdoc :

yes --this is likely autoimmune condition.

Customer:

perfect - thank you very much..we'll pursue appts with the hematologist and nephrologist as well.

mysticdoc :

very welcome

mysticdoc :

Best wishes,


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