Unknown inflammatory response

[roxy801]

I have a long standing history of viruses triggering frequent sinus inflammation/infections which quickly leads to leading to reactive airways.  Six months ago, I was getting winded  minimal activity.  A ct of the chest revealed a large pericardial effusion. A liter of blood was drained. Effusion returned and I was in tampanade so I had a pericardial window. Prior to the effusion, I had no cardiac problems and my blood work was always fine.  My IGE, C reactive protein,ANC,RDW-CV,abs mono, anion gap and compliments 3+4 have been elevated since the effusion and continue to be elevated.  

I  recently had a  ct which  states that I have small mediastidnal nodes nonspecific.

An immunologist suspects that I have mast cell activation disorder- normal triptase levels.   have had scratch allergy testing four times which were all negative.  I recently had patch testing done which showed allergy to ,
   Lidocaine, Propylene Glycol, Carba Mix,Balsam of Peru,Thiuram Mix, Lyral, cobalt (II), chloride hexahydrate,nickel sulfate


For the past three months, I have been on
Levocetirizine ,verapamil ,colcrys ,omeprazole ,cymbalta ,cromolyn sodium -nebulized

I was just started back on advair and qnasal due to recent virus and sinus inflammation/reactive airways

What is the implication of the mediastidnal nodes?
Could the very high markers of inflammation be related to the lung findings, frequent sinus infections and reactive airways for the past 30 years?  Could mast cell activation be an issue despite normal triptase levels?

I continue with sinus/bronchial problems, intermittent feeling of being winded (normal pulmonary function test), fatigue, mild brain fog, palpitations and not feeling right.

Could these things all be related?  What is the next step

[TheLightSeeker]

One more possibility that needs to be ruled out is Pathogenic Mycoplasma
and its Co-infections Babesia, Ehrlichia, Bartonella, which I'm afraid are extremely difficult to detect through standard blood testing or other tests.
My advice would be to do a search here under: "Dr Garth Nicolson"
part time Expert on MedHelp , founder of the Institute of  Molecular Medicine
and the world's top expert in this field-research and treatment!

Best wishes!
Niko

[roxy801]

Thank you for your response.  I was tested for sarcoidosis, sojourns, scleroderma, vasculitis, lupus etc. I have had chest x-rays and am definitely negative for tuberculosis. All were negative. I am also negative for parasites as confirmed by a stool sample.  When I had the pericardial window, it was biopsied and only showed markers of both acute and chronic inflammation.  No granulomas were found. Ct of the sinuses showed tissue changes consistent with chronic inflammation.

[Dr. Kokil Mathur]

Hi!
If markers of inflammation are increased and tryptase levels are normal, then either the reaction is not allergic or it is allergic and mediated through basophils (and not mast cells).  So, it could be a parasitic infection (giardiasis, amoebiasis, tape worm, round worm) or mold or tick bite (Lyme’s).
Also, you may be having an autoimmune disease response in the body and hence must have a detailed evaluation. Granulomatous diseases such as arcoidosis and tuberculosis too should be looked into. Most of these can affect the mediatstinal lymph nodes if the lung is involved. Please discuss in detail with your doctor. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.