After hearing a case study in class, Kimberly Ho was startled by the similar symptoms.
By Sandra G. Boodman Sandra G. Boodman Medical reporter and creator of the monthly Medical Mysteries column Email Bio April 20 at 11:00 AM Kimberly Ho, a newly minted nurse at Children’s National Medical Center just off a 12-hour overnight shift, struggled to focus on a presentation about working with sexually traumatized children and adolescents.
Tuyet Le stands with her daughter, Kimberly Ho. “What was hard is that I went to work and could do all these things for other families, but not for my own mother,” said Ho, who accompanied her mother to most medical appointments, often acting as interpreter and advocate. Le saw her gynecologist, who performed a biopsy. The results were inconclusive, so the doctor referred Le to a dermatologist. When the ulcers disappeared a few weeks later, Le decided there was no point seeing the specialist.
“It’s a weird thing for me to talk about this because it’s my mom’s stuff,” said Ho, who was born several years after her parents arrived in the United States. “And a lot of medical terms are hard to translate into Vietnamese.” Her primary care doctor, Huyanh Ton, ordered blood tests. Two markers that signal inflammation — erythrocyte sedimentation rate and C-reactive protein — were elevated and considerably higher than those seen in people with rheumatoid arthritis.
Ho said her mother’s episodic, debilitating illness was taking a toll on the family. She often ducked out of class to call doctors, while her normally active mother grew depressed, worried about her health and the family’s mounting medical bills.Ho confided in several professors, asking if they had any suggestions about what might be wrong. While sympathetic, none did.A passing reference in a class would change that.
A few weeks later, Le developed a quarter-size boil on her calf. The genital and oral ulcers returned.Ho persuaded her mother to see a new dermatologist. But by the time the appointment rolled around several weeks later, the sores were gone.“I showed him all the pictures I’d taken and said ‘I think she had Behcet’s,’ ” Ho recalled.
Ho said that she and the internist agreed that a formal diagnosis would hinge on a visit to a second rheumatologist, with whom Ton conferred in advance.
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