A Case of Acute Onset Anxiety in Context

of Relationship Behavioural Issues

Panic, jitters, mood swings, irrational behaviour, and extreme irritability caused extreme relationship problems in this patient’s family.  I have worried about her potential for Paill Spectrum infection for some time.  The situation rapidly deteriorated with the clinical changes matching changes in the Paill Spectrum inflammatory markers. "First wave" Paill Spectrum infective injury.

Female 32 years Old. Back to top

Well know to me on a personal basis for years.
A very personable and pleasant young woman.

.24^th July 2003.

• Simple injury to her hand last week is healing very poorly. 
• She mentions that other wounds also heal poorly. 
• She also mentions that she bruises a lot.
•  Sleeps for 6-7 hours a night: normal.
• Mentions that she often needs a nap of about 40 minutes.  “I was so tired that I was in tears yesterday.  If only I could sleep all day, I would.”

 There are minimal signs of Paill Spectrum on examination, though I am very concerned about the presence of Paill Spectrum infection on general history.

She is very “sporty” and prides herself on her slender figure.

Case 6    Comment 1

Blood tests show:
Very mild gluten allergy.
Positive Paill Spectrum inflammatory markers.

 Treatment:

• Gluten free diet
• Broad Spectrum Multivitamin
• There are no symptoms of active Paill Spectrum except tiredness, to justify antibiotic therapy

The patient is seen often over the ensuing months but continues to be well.

Case 6    Comment 2

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 26^th January, 2004 Back to top

Presents with: panic attack.

Case 6    Comment 3

She is feeling unwell with a substantial depressive overlay to her symptoms.
She is very unhappy with many antidepressants she has received in the past, as she is not happy to experience any weight gain.

  I get the distinct impression or suspicion that she has been eating poorly and dieting a lot with irregular food intake.

There are difficulties with her child that are making looking after herself properly a chore.
She says she has so little energy that she has even stopped running.  She has continued her gym class but finds she is extremely tired after the class.

 She admits to not undertaking her gluten free diet and to not taking the multivitamin.
She is often crying
There are episodes of general anxiety.

Case 6    Comment 4

She is avoiding contact with other people and her husband.
She is treating her husband very poorly, (by her own description).

•  On examination:
• No tender areas typical of Paill Spectrum illness.
• Hands OK: there is no sweatiness
• A little sway only on standing with eyes closed.

 Blood tests show that there has been a 30% spike in the level of the Paill Spectrum inflammatory marker in the last few months.

 Case 6    Comment 5

 Treatment is initiated with: Back to top

Multivitamins
Gluten free diet as possible
Specific mineral supplements
Paill Spectrum “first line” antibiotics

The initial treatments of Paill Spectrum are specified on the treatment page, but if used in children with the same clinical presentations, need to be modified for use by children in terms of both: doses of medications as well as types of medications.

Over the next three months:

• The patient’s anxiety settles a lot. 
• There are no more panic attacks. 
• The mood has become a lot better. 
• She is treating her poor suffering husband much better. 

(Even she thinks that he is a poor suffering husband, and that much of their relationship problems relate to how bad her moods have been)

 Her concentration is improved. 
She has become much calmer.
There is a lot less yelling and irritability in her behaviour. She is fighting with her husband less.

There have been substantial improvements in her behaviour symptoms on the treatment. 
She is still not perfectly well but is happier to return to many normal activities now. She is still bruising though.

• .What physical examination needs to be made ?
• What investigations are required?
• What treatment is required?
• What complications have occurred?
• What is the diagnosis? Back to top
  
  

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