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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 31200
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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my son has eyrthema nodosum which is very painful, his symptoms

Resolved Question:

my son has eyrthema nodosum which is very painful, his symptoms have been checked for sarcoidosis, he has had a lung biopsy, loads of blood cultures done, they seem to have all come back with an answer of inconclusive - he is vomiting, cant keep food down, lost over 2 stone in weight, looks like he is on deaths door. could this be something i have passed down via genes, i dont know anything about his fathers medical history as we broke up when i was 4months pregnant and have never spoken or seen him, we were born in South Africa and have been in England for 28 years, he has always been a healthy person. i am adopted so i have no medical history of my parentage, what could this possily be?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Chip replied 3 years ago.
Hi--first off has he had any studies to look at the vomiting and weight loss?
Customer: replied 3 years ago.

apparently all the tests he has had done have come back inconclusive, no test for that, he has had lymph wash done, scans of chest, abdomen, pelvic and nodes

Expert:  Dr. Chip replied 3 years ago.
Has he had upper endoscopy, a screen for H pylori and--I have to ask--a screening for HIV?
Customer: replied 3 years ago.


yes he had the endoscopy, why would he need an HIV as he is not permiscuis, he has been married for 7 years, i know this test doesnt always mean that but he is not gay and doesnt sleep around.

Expert:  Dr. Chip replied 3 years ago.
Well, even nonpromiscuous people can have HIV so I had to ask and I would screen him for that. Has he been screened for thyroid problems and for low cortisol levels?
Customer: replied 3 years ago.

all the bloods have been done, they came back clear, but its the erythema nodosum, that is my concern, he cant walk with the pain, all his joints are painful, what is low cortisol level?

Expert:  Dr. Chip replied 3 years ago.
Well, oftentimes there is no specific cause found for ED but are his doctors certain his pain is all from the ED. Cortisol is a hormone secreted by the adrenal glands.
Customer: replied 3 years ago.


it seems to be that, he but could i have passed anything to him through my genes, as he is wanting to track his fathers medical history, apparently the man died of a heart attack many years back

Expert:  Dr. Chip replied 3 years ago.
OK Mary. Yes this could be a genetics problem and there is genetic testing available for families in whom anyone of them has ED. That said, even if the gene is found, it doesn't alter the treatment for ED. That said, I'd still do some more testing like H pylori screening, HIV, cortisol levels, and unless his TSH level was below 2.5, I'd treat him for low thyroid.
Customer: replied 3 years ago.

could it have any bearing that he had a vascetomy 3 yers ago, and could that have changed the hormone level at all,

Expert:  Dr. Chip replied 3 years ago.
No Mary--that wouldn't have anything to do with what he's going through now
Customer: replied 3 years ago.

could he have tb

Expert:  Dr. Chip replied 3 years ago.
Has he been tested for that and had a chest x-ray?
Customer: replied 3 years ago.


yes to the xray &2 ct scan all proved ok, but lungs and lyph nodes in lungs are inflamed ...


 

Expert:  Dr. Chip replied 3 years ago.
How about a PPD and a sputum culture?
Customer: replied 3 years ago.

what is PPD

Expert:  Dr. Chip replied 3 years ago.
Skin test for TB--small injection making a little blister on the arm and then it's looked at in two days to see if it's gotten larger and hard
Customer: replied 3 years ago.

not to my knowledge, he had his TB jab when in year 11 i belive, the only thing that has changed in the last twelve months is that they have aquired a new dog, from a rescued kennel, when she arrived she had kennel cough which was treated, could this have anything to do with his symptoms

Expert:  Dr. Chip replied 3 years ago.
No, Mary, the dog wouldn't have anything to do with this and it doesn't sound like a TB problem for him. I still think he needs the further testing I mentioned above
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