# Mike- Leap



## Pete (Jan 20, 2000)

Mike,A stool test just showed I have charcot layden crystals. Does this mean food allergies? Is leap drawing blood in NY yet or would I still have to drive to Jersey.Thanks,Pete


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## WD40 (Jun 7, 1999)

Doesn't that normally indicate inflammation of some sort? Not sure.....Mike?


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## Mike NoLomotil (Jun 6, 2000)

Hi Pete&#8230;Mike-Leap here&#8230;.Sorry so slow these days can only find time come around about every other day for an hour or less.I remember posting on this before to someone&#8230;many moons ago...lemme see if I saved the post for speed sake. Let's look for a old post on Charcot-Leyden Crystals (these are from eosinophils, they express a lypolytic enzyme called phosphilipase Stand by while I scan the files (cue elevator music&#8230;."Eleanor Rigby picks up the rice at a Hindu vegeterian feast&#8230;cannot eat yeast&#8230;&#8221







Blank. Did not save it. So OK let me just be quick as you have been around and know the ropes.What does your WBC and differential look like? The thing that springs to mind waaayyyyy before any "food sensitivity" (these reactions are not really associated with this) is some form of eosinophilia.I cannot recall seeing eosinophilia as a pirmary type of immunocyte activation in most "abnormal immonocyte reactions" to foods of any kind anywhere in the body.Something going on in your urinary tract which is acute?What was the doc's interpretation in the context of your WBC analysis?MNL


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## Pete (Jan 20, 2000)

Mike,My bloodwork is normal. The doc said these crystals may be indicitive of a parasitic infection. He did say he saw a couple e. histolytic cysts. There is definately inflammation. I was told crohns and colitis. I flew to UCLA for second opinion and was told it could be crohns but they are not sure. They said the inflammation on biopsy doesn't resemble crohns. So I'm left with inflamation that may or may not be crohns. I don't have diarrhea or bloody stools. Mostly just bloating, reflux, and flatulence. I thought maybe the crystals were a clue? Could this be food allergy? Is Leap drawing blood in NY yet? Any thoughts? Thanks MIke


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## Pete (Jan 20, 2000)

Mike,When you say some sort of esophillia, what does this mean? Infection?


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## JackieGian (Mar 23, 2002)

Sorry to jump in here, but are you talking eosinophilic granuloma (aka histiocytosis X; aka langerhans cell histiocytosis)?


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## Mike NoLomotil (Jun 6, 2000)

Eosinophilia....tooo many eo's in the plasma or some other body compartment and yes this is an form of "inflammatory reaction" which is specific."He did say he saw a couple e. histolytic cysts. "Could be a red flag or a red herring."They said the inflammation on biopsy doesn't resemble crohns. "What did they biopsy (where)...lower colon via colonoscopy, ileocecal junction? Small bowel via a minilap? It is of interest...what did the pathology report say about the cells at the site of inflammation? What kind of infiltrate do you know?Stand by this is not done something is wrong with my computer be right back....uh ohman that was weird..had to reboot the machine.Anyway to cut to the chase, based on the fact that you have these symptoms, entamoeba cysts, and an inflammtion that is not suggestive of Crohns, I am not the doctor but I would suggest that maybe you suggest to the doc to go ahead and treat it as a case of chronic e. histo.When it is chronic, it becomes episodic with mild symptoms like you have, not necessarily the bloody diarrhea of a virulent invasive ameobic infection. In fact you may only get cysts in the stool and no diarrhea. you will get periods of gas and bloating and discomfort. You may also get diarrhea from time to time but it is not severe like dysentery would normally be.It is NOT rare that this is mistaken for IBS or inflammtory bowel disease.I would ask my doctor to select the regimen he prefers (which drug regimen) and treat me.I did this once where it sure acted like intestinal candidiasis even though the classic diagnostics were not exactly present...and a course of treatment fixed the symptoms so it was the right move.Anyway the more pieces you put together the less it looks like a red herring and the more it suggests that perhaps tio be safe it is best to treat it as one of those chronic asymptomatic infections.Anyway that is my suggestion. This does ot suggest the kind of picture that one would see either clinically on on biopsy or on stool culture for "lost otal tolerance" primary. You may have some lost oral tolerance but it looks like it may be secondary to this subtle form of amoebiasis to me, buddy.Good luck with diplomacy with the doc. I trust you have tht kind of relationship.







MNL


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## Pete (Jan 20, 2000)

Thanks Mike,The inflamation is at the terminal ileum and rectum. This was found at Mt Sinai which has very good IBD dept. They said I have crohns but that it is asymptamatic and that my upper GI symptoms are GERD/dyspepsia and are unrelated. They gave me pentasa for life. I flew to UCLA for 2nd opinion. They are not sure. Said inflammation is present but doesn't look like crohns. Talk about confusing. Finally I decided to go to a tropical disease specialist. He found the histolytica cysts, charcot layden crystals, and puss from a scraping taken during quick sigmoidoscopy. Talk about confusing. Even if histolytica is the problem, I don't see any literature that this could cause upper GI symptoms. I have noticed that sugar makes things worse. Oh well it is all a journey that I will see through. Thanks again


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## Mike NoLomotil (Jun 6, 2000)

Hi Pedro.Just one thing to reflect upon: Don't be stuck on the idea that you may have only one etioligic basis for a single condition. Comorbidity is not unheard of







"Upper GI" means you have GERD or something else too? As I fuaaily recall the symptoms you have described and the findings, if I was in your shoes, would compel me to ask the infectious disease guy to treat me for the E.H.In fact I'll spot you a fiver that you will see a reduction in many, if not all, symptoms if this is done. The medication is not dangerous but if it is asymptomatic EH then it can cause other problems later if they decide wake up and get busy and then get loose into other organ systems. CYSTS are LATENT VIABLE parasites....sometimes where there are cycts there are live ones being naughty.I am not trying to do anything but maybe encourage you to consider again the value of taking the medicine. the intestinal symptoms and findings are equivocal, for sure, but did not the tropical guy suggest that this may be the case? that you should be treated?What upper gi symptoms you have GERD?Have a good holiday buddy, be back someday. Hmm...Shane right?MNL


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