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    Old 05-23-2018, 06:17 PM   #1
    cgoetz0521
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    need input on 7 year olds rash

    Hello,

    I am new here. My daughter who is 7 years old developed what appeared to be a severe allergic reaction to some unknown antigen in mid-january this year. Her eyes were itching beyond control and hurt. I took her in and they said it didnt entirely fit the norm for allergic reaction but that is what they will say and gave me eye drops. The drops made it worst so we went to normal visine. Well 10 days into her eye thing and as that was tapering down she started getting a rash on her torso and legs. She mentioned a rash but seeing as she gets them from time to time I waved it off and told her to apply her normal lotion. A few days later she started complaining it was really itchy. Taking a look I was shocked to find huge blotches, round rashes, and hive like rashes, some would bruise as they "healed" and then flare up again. It's been almost 6 months and still no answers.

    Her derm that I finally took her to wouldnt do anything until she had the rash for 4 months, claiming viral. He did blood work and her ANA was 1:160 and speckled but her other auto-antibody tests were normal/negative. Her blood work was good ( i copied her results at the end if your interested) elevated Eosinophils which he correlates to the allergic reaction he believes she is having. She takes Zyrtec 10mg twice a day and then Hydroxizine 10mg 2 pills at night. She is on a topical steroid cream we apply twice a day to her rash (which covers most of her body). She was mostly under control with the rash just on her thighs for about a month on this regimen but if she missed her cream or a pill she'd flare up again within 24 hours. Her rash flared over this past weekend to being what it was before she was ever medicated for it. Each time she goes outside it gets significantly worst. Her once pale blush colored rash that was on her legs has again spread as a vivid red rash all over her body. It's large rasied blotchy rashes and circular rashes with a pale center. Her face appears flushed with a temp of 99F. She complains of numbness in her hands and feet, "droopy" muscles (tired or weak muscles), lack of concentration and occasional pain in her wrists or stomach. I asked him about an autoimmune problem and he said she would have a fever and her ANA would be 1000 or higher and her blood work would be all over the place.
    Can you tell me what you think. I appreciate it.


    Rest result Normal Range
    WBC 5.5 10*3/uL 4.0 - 12.0 10*3/uL
    RBC 4.46 10*6/uL 4.00 - 5.30 10*6/uL
    Hemoglobin 13.4 g/dL 11.5 - 14.5 g/dL
    Hematocrit 40.0 % 33.0 - 43.0 %
    MCV 90 fL 76 - 90 fL
    MCH 30.2 pg 25.0 - 31.0 pg
    MCHC 33.6 g/dL 32.0 - 36.0 g/dL
    Platelet Count 326 10*3/uL 150 - 450 10*3/uL
    MPV 6.9 fL 6.0 - 9.5 fL
    % Neutrophils 43.1 % 28 - 56 %
    % Lymphocytes 38.8 % 36 - 65 %
    % Monocytes 8.4 % 0 - 10 %
    % Eosinophils 8.7 % 0 - 6 %
    % Basophils 1.0 % 0 - 2 %
    Absolute Neutrophils 2.4 10*3/uL 1.1 - 6.9 10*3/uL
    Absolute Lymphocytes 2.1 10*3/uL 1.4 - 7.8 10*3/uL
    Absolute Monocytes 0.5 10*3/uL 0 - 0.6 10*3/uL
    Absolute Eosinophils 0.5 10*3/uL 0 - 0.4 10*3/uL
    Absolute Basophils 0.1 10*3/uL 0 - 0.1 10*3/uL

     
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    Old 05-24-2018, 05:33 AM   #2
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    Re: need input on 7 year olds rash

    Hi. Sorry you are going through this with your daughter. She is too young to be dealing with this!

    Unfortunately, my only suggestion is to please get her to another doctor. A rheumatologist might not be a bad idea; since this very well sounds autoimmune. A Rheumy is a good as place to start as any...do you have a children's hospital near you? If so, seeing a doctor there would be smart too as they have many specialists in peds which they can refer you to. If you do not have a children's hospital, ask around and find out if there is a pediatric rheumy you can see...

    If nothing else- please get a second opinion from another pediatrician. This one is ruling out things too quickly without doing more testing. Obviously this isn't normal and your daughter shouldn't have to suffer because the doctor isn't getting you answers!

    My friend's son went through something similar, he was diagnosed with Lupus at age 9..not saying your daughter has Lupus, but it can show up as a rash like you are describing. Get her checked out by a specialist. I hope she is okay! Prayers to both of you!
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    Old 05-24-2018, 06:42 AM   #3
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    Re: need input on 7 year olds rash

    Thank you for your reply. I go to a children's hospital now for her specialists. It's frustrating because I feel like its autoimmune but because her CBC came back normal and her ANA wasnt sky high he still thinks its just a "chronic allergic response". I actually feel like lupus is the most likely AI since I looked at the symptoms of all the most common ones and she fits the most symptoms for Lupus and not really any of the others except a rash. She got the butterfly rash right after her eyes started and then its gone away. She has a flushed type look on her cheeks but other than that no actual rash on her face. I feel at a loss and even my mother in law says she cant believe they arent moving faster on this.

     
    Old 05-24-2018, 01:03 PM   #4
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    Re: need input on 7 year olds rash

    cgoetz0521

    This Dr. Should have done a biopsy with immunofluorescent studies a long time ago, but I would not trust him as his information is totally inaccurate. I would take your little girl to a pediatric rheumatologist and a new dermatologist who knows something about lupus. ANA of 1:160 is considered clinically significant, especially in light of her symptoms. Many lupus patients get just intermittent flushing on cheeks in lieu of an actual rash. Fever doesn’t have to be a symptom although can be, especially during flares. You might see if you can get her into a children’s hospital clinic for both dermatologist and rheumatologist and insist on immunofluorescent exam if rash biopsy is done. They would be looking for a “lupus band” on that test. Blood work is ok except high eos. It might be worth doing a stool sample for ova and parasites if you have pets or she has any diarrhea. High eos occur in parasite infections of the GI tract and manifest as “tummy troubles “. Example-giardia, which dogs can carry.

    Last edited by Administrator; 05-26-2018 at 09:37 AM.

     
    Old 05-25-2018, 08:19 AM   #5
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    Re: need input on 7 year olds rash

    I just wanted to add a couple of comments to my previous response to you. If her eye symptoms come back, I would take her to an ophthalmologist because more serious eye issues can occur in autoimmune disease and identifying those can help in the diagnostic process. Also, since rashes can be fleeting or quite varied in intensity, i would take pictures with your smartphone to show the drs she sees in case rash is not present on appt day. Good job advocating for her!

    Last edited by Administrator; 05-26-2018 at 09:37 AM.

     
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    Old 05-25-2018, 10:37 AM   #6
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    Re: need input on 7 year olds rash

    It's always disturbing to hear how off-handed responses and diagnosis, without digging deeper into symptoms, can create more frustration and work for all those on the receiving end of care.

    It's not a normal thing for a 9 year old to have the type of symptoms your daughter is having.... and labeled as allergic response. I see it more as autoimmune, but she could also have allergies adding fuel. I also suggest you push for stool samples.

    She could also have an infection brewing.

    Has she had allergy testing? Gluten intolerance blood test? How are her vitamin D levels?

    Are there autoimmune disorders, liver or bowel disease in your family?

    The other thing you can also consider is genetic testing.

    It's good you have copies of all her test results.

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    Last edited by quincy; 05-25-2018 at 10:40 AM.

     
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