Archive for the ‘Auto-Immune’ Category
Chief Complaint: Joints pain for over three years
Western Diagnosis: Mixed connective tissue disease, pulmonary hypertension, scleroderma.
Medical History: A 23-year-old woman was admitted to clinic on May 5, 1997, because of joints pain around all body for over three years, skin and eyes dry, thirst and wants to drink cooled water, almost joints sour and tip of fingers’ color change to purple and whit when the weather become to cold, loss hair. Her skin on arms are dry and peeled off. She used to treat by acupuncture and Chinese herbal medicine, the symptoms were reduced but that never goes away. Recent years, she has had sense of oppress in her chest, and difficult to breath, asthma attack when she walk or go up stairs, those symptoms are gradually getting worse, but nothing could help. During 12/03-12/18/1996, she had had a high fever and went to Johns Hopkins Hospital was diagnosed as mixed connective tissue disease, pulmonary hypertension, scleroderma.
Chief Complaint: Allergy and Insomnia
Western Diagnosis: Allergy and Insomnia
Medical History: Dizziness, fatigue, frontal headache, insomnia, asthma, nausea, earache, hay fever, sinus problems. back, legs, neck and shoulders pain, Lumps in groins.
Allergic to passion fruit, chamomile, some fruits, cats, horses, goats, deers, some herbs.
Questioning exam: Allergy and asthma since pt was born and has been tested and confirmed by specialist. Symptoms included daily sneezing, itchy throat, running nose, stuffy ears, frontal headache, and frequent skin rush.
Chief Complaint: joint pain
Western Diagnosis: rheumatoid arthritis
Medical History: Female, 34 years old, physical therapist. Joint pain since she was little. Has seen regular physician. Take low dose prednisone off and on.
Ankle, knee and hip joint pain bother her a lot. Recently the both knee swollen, pain, feeling warm and affecting function.
Chief Complaint: Acne Rosacea
Medical History: The patient is a 50 year old female whose Acne Rosacea, localized mainly around her mouth and chin. During her adolescent years she was diagnosis with severe Acne by her physician. In her thirties she was diagnosis with Acne Rosacea by a Dermatologist. For past two years the outbreaks has been moderate to acute. Her lesion is diameter of an eraser on a pencil. They are pustules and painful. When the lesion breaks open, they bleed and is easily irritate. Simply splashing water on her face to wash it or wiping her mouth area with dinner napkin can cause the to lesions to bleed.
Chief Complaint: The patient suffered from dry and sore eye for seven years.
Western Diagnosis: Sjogren Syndrome
Medical History: 50+y, female. The patient suffered from dry and sore eye for seven years. She is unable to cry properly since 1999. Also, her mouth is dry and gum is sore. Accompanied Symptoms: dizziness, slight hair loss, arthralgia.
Questioning exam: Her skin is dark and rough with some pigmentation.
Chief Complaint: Severe pain, edema and stiffness of various joints for 8 weeks.
Western Diagnosis: Rheumatoid Arthritis
Medical History: Severe pain, edema and stiffness of various joints which were symmetrical and typical of RA. Joints affected included ankles, knees, hips, fingers, wrists, jaw, elbows and shoulders. Patientâ€™s mobility was very poor and she needed considerable help with her personal needs. All activities were painful, the majority severely.
Questioning exam: Dull ache with stiffness. Worse at night. Trigger by coldness and tiredness.
Chief Complaint: Pain in the Joints.
Western Diagnosis: Rheumatoid Arthritis
History: The patient complained of small joints starting in the winter from a long time. Gradually, it spread to larger joints mainly in the knee.
Symptoms: Joint Pain, Muscle pain, Body Ache, Tiredness, Stiffness, Swelling in the legs, too much weakness while doing even small work she was feeling weak.
Palpation: Pulse is thin and wiry.
Chief Complaint: red itchy skin
Western Diagnosis: psoriasis
Medical History: 38 year old male with psoriasis for 10 years. He believes it was caused by photo-processing chemicals. He has been treated with steroid-family injections but relief is temporary. He also uses creams, Ultravate and Duvanex to control itching. His pulse is slow and he exercises regularly.
Questioning exam: He states the psoriasis lesions worsen in winter, with stress, and possibly with spicy food.
Chief Complaint: Weakness of four limbs
Western Diagnosis: Myasthenia gravis
Medical History: About 6 times bowel movements with diarrhea sometimes. Cannot breathe deeply. Feel like the brain can not order limbs any more.
Questioning exam: I looked at the patient, a middle-aged woman and started to make diagnosis according to my knowledge and experience. One week prior her breathing stopped all of a sudden with serious weakness of limbs. She was taken to a hospital and stayed there for 5 days.