posted
I have problems with anemia which is completely unexplained. We have ruled out Celiac Disease and I am on a gluten free, dairy free and soy free diet. We know it's not a malabsorption problem from food.
It's not a menstrual problem because I haven't had a period in months and months. After series of iron IV treatments, my Dr. can't seem to figure out what is causing this. He is a really nice Dr. and means well, but can't figure out what is going on.
Well, my LLMD (have only seen him once...but will see him again in Feb.) called and I tested positive for babesia. I have heard anemia is associated with babs, but I am wondering if anyone can point me to info that talks about the connection.
I see the Hematologist on Friday (tomorrow) and I want to be able to show him some medical jargon talking about the connection (in hopes he will be supportive of my Lyme diagnosis )
Thanks for your help! Posts: 215 | From Student | Registered: Oct 2007
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I can't really offer any explanation, but I was wondering if you're a runner by any chance?
-------------------- The best index to a person's character is how he treats people who can't do him any good, and how he treats people who can't fight back. -Abigail van Buren (Pauline Esther Friedman) (1918-2002) Posts: 409 | From Florida | Registered: Dec 2005
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
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Babesia can cause severe anemia, absolutely. So can porphryia as it has many effects on heme.
Think exactly of what you expect from the doctor you plan to see? A window into your blood ?
I assume you made the appt. before you got the babesia results. Just tell him that and go from there.
I assume you've never seen him before and you are starting fresh. If not, maybe a fresh start of a sort.
In my experience going to show a doctor a connection NEVER worked. Not to say that it won't but be sure to put yourself in the mindset of the doctor.
You can "meet him where he is at" then share what you have just discovered regarding your TBI labs. You don't need to convince him, if he is a bright doctor, he/she will be interested in your test results while also looking at whatever else may be needed.
Can you have your LLMD's office FAX a copy of your lab report to him ? He'll want to see the report.
You can't argue the test results, it's a fact. (Although you might want to be prepared should he say "past exposure").
I'm thinking if you just let him share in the discovery process of the babesia with you it can be a good process. I hope he surprises you in a good way, sharing some of his knowledge with you. Maybe he can answer some questions or teach you about the blood. Give him a chance to be the best doctor he can be.
Might he be able to have a good look at the big picture (in case something is not connected to TBI)?
Can he check for excess porphyrins ? That could also explain anemia and be very important considering future Rx choices.
Also know that you already have one answer (there may be more) and a treatment plan if he cannot offer any other specific insights. Stay grounded and professional.
As much as we'd like the doctors who aren't familiar to become so, we have to give them a chance. And that means if they choose not to venture into this area, you simply close the door gently, leaving a copy or two for them to think about later. It may not result in them being available to us but, perhaps, for others who will come along later.
(I'd advise not using the term LLMD, but rather your lyme specialist, if you must bring him into the conversation.)
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If you go through the treatment for babesia and follow the care of your LLMD, it should resolve.
In the meantime you might ask if you could take stinging nettle supplements (standardized, best brand, of course).
It got my iron back up like a charm with far less irritation than iron meds. Anyway, only the treating doctor would know about adding iron at this point. And, different anemias cause different stuff - iron is just part of it.
Good luck and it's so good to know what to work on with hopes of good health coming along.
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[ 10. January 2008, 06:12 PM: Message edited by: Keebler ]
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
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www.ilads.org ILADS might have a good article or two.
excerpt: Infectious agents such as malaria and babesiosis invade red blood cells. From:
Am Fam Physician. 2004 Jun 1;69(11):2599-606. Links Hemolytic anemia. Dhaliwal G, Cornett PA, Tierney LM Jr.
San Francisco Veterans Affairs Medical Center/University of California-San Francisco School of Medicine, San Francisco, California 94121, USA. [email protected]
Hemolysis presents as acute or chronic anemia, reticulocytosis, or jaundice. The diagnosis is established by reticulocytosis, increased unconjugated bilirubin and lactate dehydrogenase, decreased haptoglobin, and peripheral blood smear findings.
Premature destruction of erythrocytes occurs intravascularly or extravascularly.
The etiologies of hemolysis often are categorized as acquired or hereditary. Common acquired causes of hemolytic anemia are autoimmunity, microangiopathy, and infection.
Immune-mediated hemolysis, caused by antierythrocyte antibodies, can be secondary to malignancies, autoimmune disorders, drugs, and transfusion reactions.
Microangiopathic hemolytic anemia occurs when the red cell membrane is damaged in circulation, leading to intravascular hemolysis and the appearance of schistocytes.
Infectious agents such as malaria and babesiosis invade red blood cells. Disorders of red blood cell enzymes, membranes, and hemoglobin cause hereditary hemolytic anemias. Glucose-6-phosphate dehydrogenase deficiency leads to hemolysis in the presence of oxidative stress.
Hereditary spherocytosis is characterized by spherocytes, a family history, and a negative direct antiglobulin test. Sickle cell anemia and thalassemia are hemoglobinopathies characterized by chronic hemolysis.
Are Various Babesia Species a Missed Cause for Hypereosinophilia? -- A Follow-up on the First Reported Case of Imatinib Mesylate for Idiopathic Hypereosinophilia
By James L. Schaller, MD, MAR; Glenn A. Burkland, DMD; PJ
Langhoff_Medscape General Medicine. 2007;9(1):38. �2007 Medscape_Posted 02/27/2007 Background_
When Drs. Schaller and Burkland were sent readers' responses to their 2001 MedGenMed article "Rapid and Complete Control of Idiopathic Hypereosinophilia With Imatinib Mesylate", they submitted the following reply as an update. Abstract_
Introduction: In 2001 we reported the first case of use of imatinib mesylate (Gleevec) for treatment of idiopathic hypereosinophilia syndrome (HES). These findings have been replicated in some patients with HES.
After 1 year of taking imatinib, the patient stopped this medication, and during the last 5 years the patient has not experienced a relapse. He has, however, recently been diagnosed with babesiosis. This new diagnosis might relate to his HES._
Methods: After 6 years we decided to follow up on this patient's treatment. We interviewed the patient, his son, his aunt, and 2 consulting physicians and also reviewed relevant laboratory results to determine whether his HES had returned and whether his residual morbidity had changed._
Results: The patient has had no relapse of HES and his eosinophil counts have remained low-normal. He was recently diagnosed with babesiosis, and was prescribed atovaquone and azithromycin with a significant decrease in morbidity. His eosinophil cationic protein levels have also fallen to low-normal since starting atovaquone and azithromycin._
iscussion: New Babesia species are emerging as human infections. Most do not have available antibody or polymerase chain reaction diagnostic testing at this time.
Manual differential examinations are of variable utility due to low numbers of infected red blood cells, suboptimal technique, and limited experience. Therefore, a diagnosis might need to be empirical at times, and should be based on signs and symptoms.
Conclusion: The patient has not relapsed in the 5 years that he has not been taking imatinib. Babesiosis should be added to the many possible causes of HES. It is unknown how often babesiosis causes HES as well as what percentage of HES patients have babesiosis.
posted
Thanks for the info! That helps. I don't necessarily want to bring him info, but I want to be able to back up what I say with correct info from medical journals, etc.
I have been seeing him for a while, almost a year. He knows me quite well, actually his whole office knows me.
He has ruled out every kind of anemia and the causes of it. My GI Dr. also couldn't find the cause. The thing is that it's not my hemoglobin I have problems with , it's every other iron number. It gets really out of control about every 4 months and I have to get iron IV's because for some reason any/every oral iron I have tried has no effect on my numbers.
Thanks for the info. I will look through more of it a little later.
Posts: 215 | From Student | Registered: Oct 2007
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
he's a hematologist so ask hime to take a look at your red blood cells looking for MALARIA . Ie. Tonight try to remember real hard about the time you went on vacation in the dominican republic around the time they had the malria outbreak...........a couple of years ago....
Malaria and babesia are almost identical in appearance. If you can convince him to look at your blood under a microscope and you have babesia to a degree large enough to cause anemia he will likely see it. It ie worth a shot even if you hapen to get your diseases confused and you are a bit fuzzy on your past tropical vacations.....
He will also be asking what drugs you are taking. Be aware that a lot of lyme related treatments can screw up your blood counts so try to raise the spectere of MALARIA before he focuses on the drugs you are taking..
good luck.
Posts: 1184 | From north america | Registered: Feb 2003
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
deleted - double post???
Posts: 1184 | From north america | Registered: Feb 2003
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. Ie. Tonight try to remember real hard about the time you went on vacation in the dominican republic around the time they had the malria outbreak...........a couple of years ago....
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