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Someone posted this the other day, you might already know most of it. Also,

have you been put on Cimetidine?

RECURRENT FEVERS WITHOUT KNOWN GENETIC ANOMALY

Periodic fever with Aphtous Pharyngitis Adenitis ()

What is it?

The patient suffers from recurrent attacks of fever and affects children in

early childhood, two to four years). This disease has a chronic course, but is a

benign disease with a tendency toward improvement over time. This disease was

recognised for the first time in 1987 and called Marschalls’ syndrome at that

time.

How common is it?

The frequency of is not known, but the disease appears to be more common

than generally appreciated.

What are the causes of the disease?

The exact cause of the disease is currently unknown. During periods of fever,

the immune system is activated. This activation leads to an inflammatory

response with fever and inflammation of the mouth, or throat. This inflammation

is self-limited as there are no signs of inflammation to be found between two

episodes. There is no infectious agent present during attacks.

Is it inherited?

Familial cases have been described, but no genetic cause has been found so far.

Is it contagious?

Infectious agents may play a role in the syndrome, but it is not an

infectious disease and is not contagious.

What are the main symptoms?

The main symptom is a recurrent fever, accompanied by a sore throat, mouth

ulcers, or enlarged cervical lymph nodes (an important part of the immune

system). The episodes of fever start abruptly and last for three to six days.

During episodes, the child looks very ill and complains about at least one of

the three above-mentioned symptoms. The episodes of fever are recurring every

few weeks. Between episodes, the child is asymptomatic and his activity is

normal. There is no consequence at all on the development of the child, who

looks perfectly healthy between attacks.

Is the disease the same in every child?

The main features described above are found in all affected children. However,

some children may have a milder form of the disease, or may present additional

symptoms, like malaise, joint pain, abdominal pain, headache, vomiting,

diarrhoea or cough.

How is it diagnosed?

There are no laboratory tests, or imaging procedures, specific for diagnosing

. The disease will be diagnosed based on the results of a physical

examination. Before the diagnosis is confirmed, it is mandatory to exclude all

other diseases that may present with similar symptoms.

What type of laboratory exams are needed?

Values of tests, like the erythrocyte sedimentation rate (ESR) or the C-reactive

protein (CRP) levels in the blood, are raised during attacks.

Can it be treated or cured?

There is no specific treatment to cure syndrome. The aim of the treatment

will be to control symptoms during the episodes of fever. In a large proportion

of cases, the disease will spontaneously disappeared with time.

What are the treatments?

Symptoms do not usually respond to paracetamol, or non-steroidal

anti-inflammatory drugs. A single dose of prednisone, given when symptoms first

appear, has been shown to shorten the length of an attack. However, the interval

between the episodes may also be shortened with this treatment, and the next

febrile episode may recur earlier than expected. In some patients a

tonsillectomy can be considered.

What is the prognosis (predicted outcome and course) of the disease?

The disease may last for a few years. With time, the intervals between the

febrile attacks will increase and the symptoms will resolve spontaneously.

Is it possible to recover completely?

Over the long term will spontaneously disappear, usually before adulthood.

Patients with do not develop damage. The growth and development of the

child are usually not affected by this disease.

Shumate

---------------------------------

Photos – Showcase holiday pictures in hardcover

Photo Books. You design it and we’ll bind it!

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My son has been going to Loma for specialists

since he was an infant. Did you see Dr. Jane Bork? We

went to her until she referred him to Dr. Majleesi in

Rheumatology. Our new insurance, however, will have us

going to Children's in San Diego. But they have a

satellite office here in Murrieta so no more fighting

the 215/60/91 freeway nightmare. I'm glad you finally

got a diagnosis. jennifer

--- cdffirewife <cdffirewife@...> wrote:

> MY DAUGHTER JOSCE HAS BEEN ILL SINCE OCTOBER OF 2005

> WITH NO DIAGNOSIS

> UNTIL SUNDAY!!! SHE WAS FINALLY DIAGNOSED WITH

> MARSHALL'S SYNDROME

> (). WE WERE GIVEN DIAGNOSIS OF...DIABETES,

> COLITIS, POSS WEST

> NILE VIRUS, PERITONITIS, CANCER, AND THE LIST GOES

> ON AND ON.....AN

> INFECTIOUS DISEASE DR AT LOMA LINDA CHILDRENS

> HOSPITAL FINALLY EXPLORED

> THE DIFF POSSIBILITES AND CAME TO US WITH AN ANSWER.

> IT IS GOOD TO

> FINALLY KNOW WHAT IS WRONG. SO I AM VERY OPEN TO

> ANY INFORMATION

> ANYONE MIGHT HAVE TO HELP US WITH THIS NEW

> DIAGNOSIS!!

>

>

>

>

>

>

>

__________________________________________

DSL – Something to write home about.

Just $16.99/mo. or less.

dsl.

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She was just diagnosed this Sunday, and the Dr that diagnosed her is Dr Janner.

We have some follow up appt's but not for the next few weeks. We will also be

schduling her tonsilectomy for the next coming weeks. Sorry about your son, any

advise you have would be a great help!!! Thank YOU!!!!

Jeanette Ferguson

Jen Sheahan <jensheahan@...> wrote:

My son has been going to Loma for specialists

since he was an infant. Did you see Dr. Jane Bork? We

went to her until she referred him to Dr. Majleesi in

Rheumatology. Our new insurance, however, will have us

going to Children's in San Diego. But they have a

satellite office here in Murrieta so no more fighting

the 215/60/91 freeway nightmare. I'm glad you finally

got a diagnosis. jennifer

--- cdffirewife <cdffirewife@...> wrote:

> MY DAUGHTER JOSCE HAS BEEN ILL SINCE OCTOBER OF 2005

> WITH NO DIAGNOSIS

> UNTIL SUNDAY!!! SHE WAS FINALLY DIAGNOSED WITH

> MARSHALL'S SYNDROME

> (). WE WERE GIVEN DIAGNOSIS OF...DIABETES,

> COLITIS, POSS WEST

> NILE VIRUS, PERITONITIS, CANCER, AND THE LIST GOES

> ON AND ON.....AN

> INFECTIOUS DISEASE DR AT LOMA LINDA CHILDRENS

> HOSPITAL FINALLY EXPLORED

> THE DIFF POSSIBILITES AND CAME TO US WITH AN ANSWER.

> IT IS GOOD TO

> FINALLY KNOW WHAT IS WRONG. SO I AM VERY OPEN TO

> ANY INFORMATION

> ANYONE MIGHT HAVE TO HELP US WITH THIS NEW

> DIAGNOSIS!!

>

>

>

>

>

>

>

__________________________________________

DSL – Something to write home about.

Just $16.99/mo. or less.

dsl.

Link to comment
Share on other sites

They gave us prednisone......to be given only when the fever hits.....this is

all very new to use, being that they just diagnosed her on Sunday, she has a few

follow up appointments, and we also have to schdule her tonsilectomy.

Jeanette Ferguson

Shumate <shumate_jess@...> wrote:

Someone posted this the other day, you might already know most of it. Also,

have you been put on Cimetidine?

RECURRENT FEVERS WITHOUT KNOWN GENETIC ANOMALY

Periodic fever with Aphtous Pharyngitis Adenitis ()

What is it?

The patient suffers from recurrent attacks of fever and affects children in

early childhood, two to four years). This disease has a chronic course, but is a

benign disease with a tendency toward improvement over time. This disease was

recognised for the first time in 1987 and called Marschalls’ syndrome at that

time.

How common is it?

The frequency of is not known, but the disease appears to be more common

than generally appreciated.

What are the causes of the disease?

The exact cause of the disease is currently unknown. During periods of fever,

the immune system is activated. This activation leads to an inflammatory

response with fever and inflammation of the mouth, or throat. This inflammation

is self-limited as there are no signs of inflammation to be found between two

episodes. There is no infectious agent present during attacks.

Is it inherited?

Familial cases have been described, but no genetic cause has been found so far.

Is it contagious?

Infectious agents may play a role in the syndrome, but it is not an

infectious disease and is not contagious.

What are the main symptoms?

The main symptom is a recurrent fever, accompanied by a sore throat, mouth

ulcers, or enlarged cervical lymph nodes (an important part of the immune

system). The episodes of fever start abruptly and last for three to six days.

During episodes, the child looks very ill and complains about at least one of

the three above-mentioned symptoms. The episodes of fever are recurring every

few weeks. Between episodes, the child is asymptomatic and his activity is

normal. There is no consequence at all on the development of the child, who

looks perfectly healthy between attacks.

Is the disease the same in every child?

The main features described above are found in all affected children. However,

some children may have a milder form of the disease, or may present additional

symptoms, like malaise, joint pain, abdominal pain, headache, vomiting,

diarrhoea or cough.

How is it diagnosed?

There are no laboratory tests, or imaging procedures, specific for diagnosing

. The disease will be diagnosed based on the results of a physical

examination. Before the diagnosis is confirmed, it is mandatory to exclude all

other diseases that may present with similar symptoms.

What type of laboratory exams are needed?

Values of tests, like the erythrocyte sedimentation rate (ESR) or the C-reactive

protein (CRP) levels in the blood, are raised during attacks.

Can it be treated or cured?

There is no specific treatment to cure syndrome. The aim of the treatment

will be to control symptoms during the episodes of fever. In a large proportion

of cases, the disease will spontaneously disappeared with time.

What are the treatments?

Symptoms do not usually respond to paracetamol, or non-steroidal

anti-inflammatory drugs. A single dose of prednisone, given when symptoms first

appear, has been shown to shorten the length of an attack. However, the interval

between the episodes may also be shortened with this treatment, and the next

febrile episode may recur earlier than expected. In some patients a

tonsillectomy can be considered.

What is the prognosis (predicted outcome and course) of the disease?

The disease may last for a few years. With time, the intervals between the

febrile attacks will increase and the symptoms will resolve spontaneously.

Is it possible to recover completely?

Over the long term will spontaneously disappear, usually before adulthood.

Patients with do not develop damage. The growth and development of the

child are usually not affected by this disease.

Shumate

---------------------------------

Photos – Showcase holiday pictures in hardcover

Photo Books. You design it and we’ll bind it!

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Share on other sites

  • 3 years later...
Guest guest

Hi all,

Well I had my blood test done on Monday and phoned through for the results today

- the nurse started going through the list telling me everything was 'normal',

including free T4 which was 12.1 (range 10-23). Then she got to my TSH, which

was 6.1 (not sure of lower range but upper range is 5.5, so my result isn't that

abnormal - but abnormal enough to finally get recognition that I can finally get

some help)

Apparently my GP has already put a letter in the post confirming that I have an

underactive thyroid and I have have to make an appointment to go and see him,

which I have arranged to do for next Wednesday.

I know it might sound insane(!!) but I am soooo happy!! I even apologised to

the nurse for being so pleased that they had found something 'physically' wrong

as I thought I was losing my marbles - but she agreed with my list of symptoms

and feeling symptomatic for such a long time that it must be a relief to know

that this can now be treated.

I just want to say a HUGE THANKYOU to everyone who has given me advice, it has

been very hard almost knowing that 'something' was wrong but meeting the

blockade at the doctors with them telling me that everything was 'normal'. To

be honest, if it wasn't for your advice I would have given up on this a long

time ago and just been a dutiful patient and beleived that nothing was wrong -

so again thank you so much!!

By the way, if anyone has any advice regarding how I should handle my meeting

with the GP other than me saying 'I told you so...' lol, I would be really

grateful xxx

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Guest guest

Hi ,

I hope this is the start of a better future for you , but we

are here if you have more questions.

FINALLY!!!

Hi all,

Well I had my blood test done on Monday and phoned through for the

results today - the nurse started going through the list telling me

everything was 'normal', including free T4 which was 12.1 (range 10-23).

Then she got to my TSH, which was 6.1 (not sure of lower range but upper

range is 5.5, so my

I know it might sound insane(!!) but I am soooo happy!! I even

apologised to the nurse for being so pleased that they had found

something 'physically' wrong as I thought I was losing my marbles - but

she agreed with my list of symptoms and feeling symptomatic for such a

long time that it must be a relief to know that this can now be treated.

I just want to say a HUGE THANKYOU to everyone who has given me advice,

it has been very hard almost knowing that 'something' was wrong but

meeting the

------------------------------------

TPA is not medically qualified. Consult with a qualified medical

practitioner before changing medication.

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Guest guest

Hi - it is ONLY in the UK that a doctor would tell you

your TSH is " slightly raised " and that is because the reference range

in the UK is massive. About the widest in the world. It is 0.5 to 10.0. Had you

been living in the USA with a TSH of 6.1 this would be considered high as the

recommended reference range for TSH is 0.3 to 3.0 and in Germany 0.3 to 2.5

with a recommendation this be dropped further to 0.3 to 1.5. Your TSH is far

too high. They should have tested your Free T4 and also checked to see if

you have antibodies to your thyroid. TSH is insufficient on its own. However,

giving you thyroxine should start to make you feel better, and hopefully,

it will be sufficient (once you are on the right dose) to bring your TSH down,

but you will need regular check-ups to see if this is working.

Perhaps if your GP had been given the training about the

metabolic system, he would actually know that hypothyroidism is all about

having a low metabolism which makes you feel tired and has lots of other

symptoms which you can check in our web site www.tpa-uk.org.uk

.. It would not be acceptable to bring your levels down below 5.0 and for you to

still experience symptoms. They would need to investigate further as to the

reasons why you still had symptoms and there are various reasons this might be

the case. But, if and when that happens (and let's hope Eltroxin works for you),

we can deal with that matter then. You will have to take thyroxine for the rest

of your life.

For some people, they feel an almost instantaneous effect - it

doesn't always take 12 months. The problem with hypothyroidism is that

doctors rely on blood results to let them know whether the thyroxine is

working, they take little heed of a patient's symptoms, which they should. They

also pay little heed to whether a patient is able to convert the mainly

inactive thyroxine (T4) to the active hormone T3. It is T3 your body needs, not

T4 - but if you are able to convert OK, then this medication will gradually get

rid of your tiredness and all the other symptoms you are experiencing right

now.

Keep an eye on what you consider could be a swelling in your

neck - if it grows or give you trouble, ask your GP for a referral to an

endocrinologist. Also the rash could be hives, something many hypothyroid

sufferers experience. Again, check this out in our symptoms list. Did your GP

give you any medication for this " fungal infection " ?

Luv - Sheila

So, I have been prescribed 50mg of Eltroxin. I have to go back and have another

blood test in 6 weeks time and if necessary the dosage adjusted and have blood tests every 6 weeks til they are happy

with my results and then go back every 3 months to be monitored.

Can anyone give me an idea as to what levels they would consider as

'satisfactory' - i.e if my levels were to come back down to around 5, would

they consider that this was acceptable - even though I know I still felt just

as bad??

He's told me that it could take as long as 12 months for it to have an effect,

which is a bit daunting - but I am happy that there is a glimmer of light at

the end of the tunnel now and that I am finally being taken seriously!

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.0.238 / Virus Database: 270.12.6/2084 - Release Date: 04/28/09

18:02:00

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Guest guest

Hi Sheila,

Thanks for your advise!

Yes he has given me some cream for the rash - Terbinafine Hydrochloride, so I'll

see how it goes!

I did test postive for antibodies last year, my count was 832 (it was explained

to me at the time these antibodies would destroy my thyroid - but I didn't need

any further treatment as I was BORDERLINE) I did query Hashimotos with another

GP a couple of months ago (same practice) and told her I had a sister with this

- but she told me I definately DIDN'T have hashimoto's and there is no family

link?! So, when I saw this GP yesterday and he asked me about family history I

thought it was somewhat funny and told him about about my sister and again

queried the hashimotos - but he confirmed I DON'T have this as I would have been

'hyper' first....

The only other result that came back relating to my thyroid was free T4 - 12.1

(range 10-23) so I don't now, if at all how relevant this is.

Basically he has told me that the reason I now have an underactive thyroid is

'just one of those things' - age related and the fact I have had children - I

have 4 girls, aged 13, 11, 9 & 7....so with him saying this it still makes me

wonder if I have been treated for depression and given anti-depressants that I

didn't need for nearly 5 years!! But I guess I will truly never know - all I

know is that since I made the decision to STOP taking them, I actually don't

feel so 'insane'!! lol I think they were completely messing with my head!

I will also keep an eye on this swelling in my neck!! My hubby can feel it, so

can my other sister - I do tend (not pleasant) to gag an awful lot but mainly

when I am stressed, I do suffer from terrible anxiety :( I also find swallowing

very uncomfortable on occasions - but the feeling on swallowing isn't in my

throat - it feels further down - sometimes I have terrible pain and have to

drink lots of water to 'help' whatever I am eating go down and this hurts!! But

again, I think this is more to do with anxiety - and this is what my GP thinks.

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