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Re: The case of the Red Pelvis.From: Anna Meenan, MD (annam@uic.edu)Mon Jun 5 12:22:44 2000
At Fri, 26 May 2000, Braun, R. Daniel wrote: > >Help me out here guys and Gals. > >24 y/o mentally retarded, G0 LMP 4 years ago using Depo for last 6 years for >contraception and menstrual hygiene. Has been complaining of pain in lower >abdomen for about 2 years. Seems to occur irregulary 3-4 times a month and >lasts for 1-2 days when present. probably a continuous dull pain. She lives >with her Mother and the pain description is based on the Mothers >observations. Pelvic ultrasound normal. UA and C&S of urine normal. No >problems noted with BM's. > Pelvic exam WNL and EUA WNL >Laparoscopy shows Normal pelvis with the exception of a hyperemia of the >pelvic peritoneum, uterus and adnexa. Ovaries not hyperemic. If you were >looking at a throat, you would say injected, not inflamed. There are no >dilated pelvic veins noted in the broad lig. or elsewhere. >Any ideas? > >Dan > Sorry to take so long to respond, but I needed to check some ancient history and the chart was in the warehouse. I had a patient years ago who had a very similar thing. She was in her early 20's at the time. Abdominal pains, mega-work-up, including laparoscopy, which showed injection/hyperemia of the entire pelvic serosa. No pus, cultures negative. She was not my patient at the time, so I got a lot of this third-hand from her memory and the records. She had been on a bunch of antibiotics before the lap. They put her on metronidazole for three weeks after the lap and sx resolved and have never recurred. I don't know if they were even clear on what they were treating exactly at the time. She has not had any recurrence and went on to have 2 normal term pregnancies in the ensuing years. The only other interesting bits of information are that she was found to be HLA-B27 positive shortly after the whole episode, and I just talked to her last night and she tells me that she has undergone premature menopause, starting about age 37, even though her mom was in her 50's when she got menopausal. Don't know what to make of it except that maybe it's some rare autoimmune thing that I've never heard of. Just thought you might be interested in a similar case.
-- Anna Meenan, MD
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