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Doctors Lounge - Gastroenterology Answers
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| Teddy23
- Mon Sep 08, 2008 12:51 pm |
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June 6, 2008 C.T. Scan of my abdomen showed that liver is enlarged and measures 19 cms. Multiple tiny illdefined lesions are seen scattered in both lobes of the liver. Mild thickening was seen in caecum proximal ascending colon and terminal ileum with involvement of the ileocaecal junction with accentuated enhancement of walls and mil pericaecal fat stranding. The conlusion was "in view of hepatic lesions possibility of Granulomotous disease(Tuberculous eiotlogy) seems more likely
Consequently I was put on AKT. While on medication I started getting pain in finger, toe joints, knee, shoulder joint and muscular pain. Added to this is sleeplessness. Blood check shows increase in Uric acid level 10.5 mg/dl. On medication, the uric acide level dropped to 4.2 mg/dl. Yet I suffer with pain in joints. I am unable to stand or sit for an extended period of time and I feel tired.
I took a CT scan three months later. The report shows complete resolution of the ileo caecal wall and no residual disease in this region. However Hepatic granulomas appeared more or less unchanged. The ACE is 90 U/L.
Are these lesion in the liver Kochs or is it different? Why I am suffering with joint pain and muscle pain? Calcium level and BMD is normal. I feel that my vision and memory is also affected.
Please advise
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| John Kenyon, CNA
- Tue Sep 16, 2008 10:43 pm |
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 Hello -
The diagnois would seem to match well with Koch's, but were you given a TB test? A positive result would seemingly confirm the tubercular Koch's disease, and would likely also explain the joint pain. Also, are you routinely immunocompromised? This variant (extrapulmonary) TB is often seen in people with compromised immune systems.
More information would definitely be helpful in making an educated guess, but so would a simple TB test, which would likely confirm what would appear to be Koch's. Also, since much of the problem did respond positively to AKT, this would seem to make the diagnois likely. The TB test, I must reiterate, would probably yield a definitive answer.
If you have more history or other information to provide, please do so. Otherwise, best of luck to you. It would seem you are slowly making progress.
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