Hypogammaglobulinemia among others
December 16, 2011 | 10,00 EUR | answered by Dr. med. Ralf Berg
Good evening,
I (female, 42 years old, aspiring naturopath) have been suffering from the following symptoms for some time:
- Dizziness, blurred vision
- Extreme fatigue
- Unusual muscle weakness during exertion, feeling of weakness
- Sometimes intense night sweats, and I sweat very easily with any exertion
- Sometimes severe itching, especially on the legs
- Frequent headaches and/or neck pain
- Skin rash (red merging dots, especially on the face and hands)
I have had hypertension for 6-7 years, which is well controlled with medication. My gallbladder was removed in late 2008, as it was porcelain-like. I had EBV with hepatosplenomegaly in 2007 - Gamma-GT was approximately 500 at that time.
In the hospital, an ENT consultation revealed a dysfunction of the right balance apparatus. An MRI showed isolated unspecific pentriventricular lesions in the brain. A lumbar puncture revealed identical oligoclonal bands in the blood and serum, and it was suggested that a possible oligoclonal gammopathy should be ruled out. Lyme disease titers were slightly elevated.
Following this, my primary care physician performed blood tests, and almost everything (ESR, ANA, Cr-P, leukocytes, etc.) was normal, except for elevated liver values (which had not been an issue after the cholecystectomy) and decreased gamma globulin levels (I don't have the details in front of me, but for example, Gamma-GT was significantly elevated at 100). Liver ultrasound will be done next week.
Somehow, none of this seems to fit together, and we are now a bit puzzled. Do you have any suggestions? My immune system has actually been functioning quite well so far (I can't remember the last time I had a cold, for example...). Could there be something malignant at play?
Thank you in advance for your help!
Dear Inquirer!
I hope you understand that such a complex issue cannot be fully resolved here for 10 euros and the possibilities over the internet are limited.
But now to your question: Could something malign be at play?
1. Generally, despite all the examinations, something malign could still be at play in the early stages. It is the nature of a tumorous disease to only cause pain in the advanced stages. However,
2. It is not very likely. All neurological disorders are possible, not just a tumor. A possible chronic (e.g. AML), episodic (e.g. MS), or tumorous (e.g. Glioblastoma) neurological disease has been tried to be detected as best as possible through lumbar puncture and MRI.
Unfortunately, your symptoms are all "nonspecific", meaning they do not point to a specific disease or organ system, but rather to a neurological event.
The planned further ultrasound of the liver or liver metabolism is certainly correct, even though personally, I believe that nothing conclusive will be discovered here.
Therefore, I would advise you to visit a neurologist again with all findings. If possible, seek a colleague who is very knowledgeable in the diagnosis and treatment of MS = Multiple Sclerosis. In total, the symptoms you described would most likely fit this diagnosis.
(Of course, it is still possible that you are simply experiencing a temporary psychological/physical overload (exam stress?, family relations, lack of sleep)). Given the severity, a further medical investigation and observation are certainly justified.
As I mentioned, I would keep an eye on the nervous system and monitor it, as MS tends to have a relapsing-remitting course and is one of the more common neurological diseases. This would be my advice.
I would greatly appreciate it if you could provide me with a brief update on how things progressed for you, or if anything was discovered.
With best regards, Dr. R. Berg
