I know,It has been a long time since I have posted about dhyey. In this post I am sharing how he was diagnosed with arthritis, his history and some clinical tests performed.
Dhyey was born by LSCS operation for non-prograssive labour. Birth weight was 3.3 kg. he required hospitalization From 19/3/2009 to 28/03/2009 for meconium aspiration syndrome with sepsis with neonatal jaundice.
In March,2010 he was hospitalized for 6 days for pneumonia.
In july,2010 he caught in severe chickenpox, and recovered after a month.
In October,2010 Dhyey had Fever 103-104F, Skin rashes again , joint pain,& swelling. He was treated with antibiotics,NSAIDs like paracitamol,Nimesulide,Mefenamic acid,Naproxen etc. antimalarial was also given. There was no response to any of these drugs.
After that I moved to Mumbai, and started treatment at Yewale hospital on 1/11/2010.
performed investigations showed anaemia,leucocytosis, normal platelets, raised ESR, LDH &ferritin. S.Proteins & SGPT were WNL(within normal limits). Hbs Ag test was negative. ASO Titre normal. Urine routine examination was normal. Xray skull was reported as normal. CT Scan study of chest,abdomen & pelvis showed hepatosplenomegaly & multiple enlarged lymphnodes. Lymphnodes were noted in both axillae,illac&inguinal regions.
Investigations(30/11/2010) showed anaemia(hb 7.5/dl),leucocytosys(TLC 18,400/cu.mm) with normal DLC. Platelets normal ESR &CRP are raised.RFT,LFT &Electrolytes are WNL.ANA &RA Factor Negative.LDH & ferritin raised. ELISA testes for HIV Negative. CXR &Sonography Showing hepatosplenomegaly with generalized lymphademopathy. ,
In December,2010 I visited To Dr. Baldev Prajapati First time, at that time Fever 103-104F, Skin rashes again , joint pain,& swelling, and morning stiffness. Multiple joint swelling noted. Multiple , significant (>2cm in size) lymphnodes over cervical , axillary &inguinal region noted.liver 3 cm in size& spleen 2 cm on palpation. repeat tests for HIV were done, Dr.Prajapati advised for lymphnode biopsy and skin biopsy by Dr. Parthiv shah, and visit to Hematologist Dr. Ashwin Patel
Dr.Ashwin Patel suggested tests for immunoglobulin and immunodeficiency and he did blood testing of mine too.
Report of Biopsy showed unspecific nodes.
Dr. was almost sure that dhyey had a symptoms of arthritis, so he advised to visit pediatric rheumatologist Dr. R.P.Khubchandani.
In January,2011 we visited to Dr.R.P.Khubchandani, Dr. told us to admit Dhyey for 3 days under observation at Jaslok hospital. Dhyey was hospitalized from 10/01/11 to 13/01/11. at the time of discharge he was 60% fine than the time he was admitted. Next step was , We had to start the methotrexate injections weekly ,some steroids everyday. Like most parents we were scared and did not want to give it to Dhyey. I asked many questions to Dr.”how will all medicines affect my child?, what are the long term effects of it, etc” Dr. described nicely that we will have great benefits than side effects. we prayed hard and put it in God’s hands because Dhyey had really no good luck for a couple months. We agreed with Dr.’s suggestions .we were told to meet him after one month with his blood test reports.
In February ,2011 we went to Dr. with reports. Dr. found raised WBC and some infections, but again medication helped him walk again. In short Dhyey’s arthritis was manageable with medicines. Dr. had a plan to reduce steroids in next visits.
Next appointment was settled on last week of march,2011, dr. found him very playful, no more complaints he was able to walk properly, and still with some infection but Dr. added that it will take some time to recovered. Infact we were also satisfied with his activities and recovery that he was getting. My Strong little boy always amazes me with his bravery and strength. on his birthday I asked God, is this a life of 2 years old???
Dhyey was born by LSCS operation for non-prograssive labour. Birth weight was 3.3 kg. he required hospitalization From 19/3/2009 to 28/03/2009 for meconium aspiration syndrome with sepsis with neonatal jaundice.
In March,2010 he was hospitalized for 6 days for pneumonia.
In july,2010 he caught in severe chickenpox, and recovered after a month.
In October,2010 Dhyey had Fever 103-104F, Skin rashes again , joint pain,& swelling. He was treated with antibiotics,NSAIDs like paracitamol,Nimesulide,Mefenamic acid,Naproxen etc. antimalarial was also given. There was no response to any of these drugs.
After that I moved to Mumbai, and started treatment at Yewale hospital on 1/11/2010.
performed investigations showed anaemia,leucocytosis, normal platelets, raised ESR, LDH &ferritin. S.Proteins & SGPT were WNL(within normal limits). Hbs Ag test was negative. ASO Titre normal. Urine routine examination was normal. Xray skull was reported as normal. CT Scan study of chest,abdomen & pelvis showed hepatosplenomegaly & multiple enlarged lymphnodes. Lymphnodes were noted in both axillae,illac&inguinal regions.
Investigations(30/11/2010) showed anaemia(hb 7.5/dl),leucocytosys(TLC 18,400/cu.mm) with normal DLC. Platelets normal ESR &CRP are raised.RFT,LFT &Electrolytes are WNL.ANA &RA Factor Negative.LDH & ferritin raised. ELISA testes for HIV Negative. CXR &Sonography Showing hepatosplenomegaly with generalized lymphademopathy. ,
In December,2010 I visited To Dr. Baldev Prajapati First time, at that time Fever 103-104F, Skin rashes again , joint pain,& swelling, and morning stiffness. Multiple joint swelling noted. Multiple , significant (>2cm in size) lymphnodes over cervical , axillary &inguinal region noted.liver 3 cm in size& spleen 2 cm on palpation. repeat tests for HIV were done, Dr.Prajapati advised for lymphnode biopsy and skin biopsy by Dr. Parthiv shah, and visit to Hematologist Dr. Ashwin Patel
Dr.Ashwin Patel suggested tests for immunoglobulin and immunodeficiency and he did blood testing of mine too.
Report of Biopsy showed unspecific nodes.
Dr. was almost sure that dhyey had a symptoms of arthritis, so he advised to visit pediatric rheumatologist Dr. R.P.Khubchandani.
In January,2011 we visited to Dr.R.P.Khubchandani, Dr. told us to admit Dhyey for 3 days under observation at Jaslok hospital. Dhyey was hospitalized from 10/01/11 to 13/01/11. at the time of discharge he was 60% fine than the time he was admitted. Next step was , We had to start the methotrexate injections weekly ,some steroids everyday. Like most parents we were scared and did not want to give it to Dhyey. I asked many questions to Dr.”how will all medicines affect my child?, what are the long term effects of it, etc” Dr. described nicely that we will have great benefits than side effects. we prayed hard and put it in God’s hands because Dhyey had really no good luck for a couple months. We agreed with Dr.’s suggestions .we were told to meet him after one month with his blood test reports.
In February ,2011 we went to Dr. with reports. Dr. found raised WBC and some infections, but again medication helped him walk again. In short Dhyey’s arthritis was manageable with medicines. Dr. had a plan to reduce steroids in next visits.
Next appointment was settled on last week of march,2011, dr. found him very playful, no more complaints he was able to walk properly, and still with some infection but Dr. added that it will take some time to recovered. Infact we were also satisfied with his activities and recovery that he was getting. My Strong little boy always amazes me with his bravery and strength. on his birthday I asked God, is this a life of 2 years old???
