Unknown case

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Whisker Barrel Cortex

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Here's a case for you diagnosticians out there. This is not a thread seeking advice. This is a 23 y/o guy from another forum. I've got my theories as to the diagnosis. Posts are cut and pase from multiple different posts by the same guy.

First it was just possible nerve damage w/Crushed Artery and maybe Compartmental Syndrome, then it was Fibromyalgia, now its some rare disease that does a lot of really bad stuff. I'm doing a 24 hour urine collection thing to test my cortisol levels right now, I think the stress of the last few months has gotten to me in the form of Stomach Ulcers as well. They think that on top of the Cushing's Disease I may also have Thoracic Outlet Syndrome and they still haven't ruled out a whole host of other problems, the doctor seemed shocked and said we're "just scratching the tip of the iceberg right now", I'm sure you can understand how comforting that was.

I suppose on the bright side I should feel lucky that they caught all this relatively early, my family has a long history of problems with the patuitary(sp?) and adrenal glands as well as spinal and other neurological disorders, and here I thought I was going to get away with just osteoarthritis.

Well the issue with my arms was very poor circulation and loss of control when I lifted them above shoulder height or tried to maintain them at shoulder height, my arms gradually got weak and shakey and then just dropped of their own accord. They are also ultra sensitive and having even swedish massage causes a great deal of pain and irritation. When I sleep and roll over onto my side in the night they go numb and theres a great deal of pain at the joint. I also experience what they call "abnormal blood loss" when I raise my arms above my head.

The problem with my legs was that I can't stand or walk without pain, running is out of the question, the blood starts to rush to the surface of the skin and appears to be pooling below the knee.

The reason they suggested cushings was the condition of my skin, I bruise exceptionally easy, after I became physically incapable of doing kickboxing for even a single class a week I gained a great deal of weight, but only in my upper torso and then what I thought were stretch marks from rapid muscle growth (biceps, sides of the abdomen, thigh's and groin) took on a more sinister meaning to the doctor than they did to me at first.

As sad as it is I will admit I have also experienced a loss of appetite and a loss of sex drive as well as a fleshy "hump" type thing starting to form that I thought was just from bad posture from years spent in my computer chair.

Dr. hasn't definitely diagnosed Cushing's but he has ruled out arthritic problems and any underlying muscle disease it might have been. I may need to see a neurologist as well because he says there is a possibility that I could have an extra vertabrae in my neck, unlikely but possible.

Noticed first signs of it a few years ago

Yes, I had been doing Mixed Martial Arts Fighters Training 5 days a week with 2 days light cardio or circuit training and '"rest" for several years, I had been in peak physical shape until the complications with my legs and shoulders forced me out of training. They initially thought it was either compartmental syndrome or fibromyalgia brought on by the intense physical trauma accrued over several years of high impact martial arts.

The problem is getting increasingly worse, I'm in pain all the time now, I went to the doctors office the first time two months ago because it was impacting my ability to do my job, at the time they had me run some tests for Cushing's Disease and sent me to a Rheumatologist who's findings came back inconclusive. I was supposed to have a Cervical MRI and Vascular studies but the doctors fooled around for a month and a half instead of scheduling it.

I've had a lot of physical injuries but no major diseases/illnesses since I was 15 (got pneumonia once, was enough to scare me into taking better care of myself), the doctors have been running all kinds of tests and I still get to see one last sports med doctor on the 26th before my insurance cuts off permanently. Other than that I'm screwed until I can get disability or unemployment or something, but as it stands right now I'm in so much pain that going back to work right away is unlikely. Though after working steadily the last 9 and a half years being out of work is going to be difficult to adjust to."


The only test result so far is what he calls a normal 24 hr urine for cortisol, but the doctors still consider Cushings.

Anybody able to put this all together. I"ve got a theory that seems to fit pretty well. There is no answer yet by the way.

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That was my theory too. A pituitary adenoma causing the Cushing's and a parathyroid adenoma causing hyperparathyroidism and hypercalcemia was my thought. A lot of the symptoms seem to fit hypercalcemia. Any other theories?
 
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I think Cushing's is a possibility. I would also think about some sort of small vessel vasculitis causing the neuropathy, GI upset uetc. Could also be a primary demylenating disorder, sarcoid, lymphoma, mixed connective tissue disease. Just some guesses.
 
I think we should call Dr. House for a consult.

(sorry, had to be said)
 
So his CBC, lytes, BUN/Cr are all normal. His calcium is high normal. I geuss hyperparathryoidism is unlikely. I was thinking about a vasculitis, but couldn't find one that fit his description well. Any chance exogenous steroids or withdrawal (he was an athelete) could cause these types of symptoms?
 
What about reflex sympathetic dystrophy? could fit with the mskl sxs. and vasodilitation/abnormal blood flow.
 
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