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Impossible case to diagnose? Who can help solve this ... ?

I am looking for any help I can get. Hopefully this doesn’t turn into a “progress log,” but I fear it might.

Background:
29 year old white male, 6’1 185 lbs, athletic build. Works out 4-5x/week since age 16. Eats a balanced and healthy diet rich in fruits and lean animal meats as well as complex carbohydrates. Drinks 1x / month on average (but binges when he does drink). No recreational drug use.  No sodas, no hydrogenated oils, and no high fructose corn syrup consumption. Use of ‘pro hormones’ while playing collegiate sports (roughly 3 years off and on). Use of creatine and protein supplements off and on for over 8 years.

Prior medical history:
Wisdom teeth removed in 2001.  2 shoulder surgeries in 2003 & 2004.  Pink eye in 2012.

First blood test in 2008 – roughly 8 complete blood work ups to date.

History of high cholesterol
History of low white blood count (3.0 – 3.5)
History of high c02 levels in blood
History of slightly low absolute neutrophils

Otherwise unremarkable (CBC, hematology, immunology, Lipid Panels, Cardiac blood studies, chemistry, Coagulation, metabolic panel, allergens, microbiology molecular diagnostics, HIV, urine, fecal)

Symptoms (related and/or unrelated):
2008-present – body acne that does not dramatically respond to any treatment.
2009- present - felt “off” (minor fatigue)
2011 – present – mild sweating (mostly at night or sometimes after eating). Never drenching sweats though.
2013- sensations of shortness of breath. Woken up at night sometimes with lump in throat. Twice admitted self to ER for this. All tests were ok. – diagnosed as anxiety or panic attacks. This has subsided over the past 6 months.

Leading us to the
Chief complaint:
Nov 2014 – itching all over body  – mostly localized in groin area – also eyelids and legs were very noticeable.

patchy raised rash on lower left back (about the size of a band aid and was pink & looks like chicken skin) – tested for all common STDs – all negative. – doctors + dermatologist said it wasn’t much to worry about and figured it was caused by stress  and/or a viral, fungal or bacterial infection.
Dermatologist also found warts on penile shaft and froze and removed them. Furthermore, she found Molluscum contagiosum which went away on its own after 2 weeks.  I also had brown (non-raised) spots on penile head and a rash-like pain on inner thighs with no rash or visible symptoms. Dermatologist was not worried by either of these two symptoms. The rash-like pain subsided after about two months but I am still stuck with those brown spots, although they have faded.

Pain in testicles. comes and goes.

Pain in stomach (mostly a burning feeling consistent with the feeling of food poisoning + mild nausea).

minor headaches that come and go.

Feb 2015 – swollen lymph nodes on right side (neck and groin). Not larger than 1cm -clinically insignificant.

Pain in joints – hands, knee, back, shoulder + stiff neck after awaking in the morning.

Occasional low body temperature. As low as 95.5 * at one point in the early morning. Usually around 97.5.

Mucous around stools. Mostly loose stools with the occasional firm stool. Slightly pale but not too unordinary. No blood in stools. Occasional black specks as well as white - yellow strands in feces.

Today – still suffering stomach pains (mild burning + minor cramping feeling). Appetite is good. Feeling dehydrated no matter how much liquid I consume. Mild nausea at times, usually after meals. Lots of gas and bloating. Gas smells very bad.

Tests & treatments:
Numerous  blood tests as mentioned above.

H Pylori test negative via stool & blood.

Endoscopy –erythema in the antrum compatible with possible gastritis.  Polyp (4mm) in the stomach body – biopsied. Otherwise unremarkable. Biopsy came back negative for all tissue samples.

Stool test – unremarkable

Abdominal/ pelvic CT scan w/ contrast –mild thoracolumbar degenerative changes present. Otherwise unremarkable.

Ultrasound – normal abdominal ultrasound

Colonoscopy – unremarkable

Most recent blood test:

lymes disease – negative

brucella – negative

TB – negative

HEP C & B – Negative

Ds DNA Ab IgG – non detected

HIV 1 – Neg

Lipase – 159 unit/L

AST – 19 Intl_unit/
ALT – 44 Intl_unit/
ALP – 56 Intl_unit/

Bili Total – 0.5 mg/dl
Bili Direct – 0.1 mg/dl
Total protein - 7.7 g/dl
Albumin – 4.7 g/dl

BHCG Tumor Marker - 24.0
Amylase – 43 Intl_unit/
Sed Rate – 6mm/hr

LD – 112 Intl_unit/

Stool culture :
No PMNs seen,  no WBCs, no erythrocytes (RBC’s) , no Ova or Parasites observed.  Giardia Lamblia Ag - Negative.

Gc Pb Amplfd Ur – negative
Chlm Pb Amplfd Ur – negative
HSV2 – negative
CRP Calc - .26 mg/dl
RPR. . - non – reactive

eGFR - >90

C02 – 32 mEq/l

PPI’s – taken for 2 months. Symptoms improved slightly but not much.

Gluten free diet for a month – very little improvement seen, if any.

Been eating “easily digested foods” for 6 weeks. Slight improvement but not much.

On Dr. Gary Chen’s teas for 4 weeks now. Little improvement. Seemed to help at first but now back to normal pains & discomfort.

Today:
Stomach discomfort typical with bloating, and feelings of dehydration no matter how much fluids I drink. I have very bad gas as well as mild nausea after eating. Since November, my pain gradually became worse until it peaked in February, and now it is back to a dull pain. I’m pushing for an MRI with contrast as well as an endoscopic ultrasound, but my insurance is denying it and my doctors do not feel it is very necessary.

I’m posting here for direction and/or advice.  I’m at a loss and went from an extremely healthy person to not even wanting to hardly do a thing.  I have not been 100% pain free since this all started. I just want my life back. I realize and fear that this may not happen. Hoping for the best...
2 Responses
1780921 tn?1499301793
Have you been checked to see if you might possibly have Crohn's Disease?
Avatar universal
I feel your pain I've had a bunch of test and they can not figure out what is wrong with me and it ***** so bad I to want my life back. I will tell you first you will probly never find an answer on the net, I've been trying for months. Second some of your problems are from stress. I had a breakdown after my house burned down years ago and I thought I was dying. It started with nause then throwing up then mucus in my stools then weight loss and all  kind of weird symtoms in between. Had so many test and the never figured it out. After a year I said F it and just tried to do stuff and all of it went away. Now I'm having some pubic and growing issues, that I don't think can be stress but maybe. I'm getting All these test and nothing is showing up. I'm at loss. But even at the moment I have mucus in my stools and stomach issues which I no is from the stress of the unexplained pain I'm in. I'm not sure what to do but I feel your pain. If you do figure anything out please send me a message and let me know thanks and good luck.
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