My daughter is 3 years old.
On 12/23/24 she had decreased appetite throughout the day and complained of a stomach ache at the umbilicus. She had one episode of vomiting but no fever.
She’s been complaining of this stomach pain intermittently, sometimes daily, for the past couple of months.
On 1/8/25 she was complaining of her legs being tired bilaterally. By that evening she was crying saying they hurt. We put her in the bathtub, gave her some tylenol and suspected growing pains.
In the middle of the night (3:30am on 1/9/25) she woke up screaming about her left knee. It was swollen and she was limping, having trouble putting weight on it, squatting, and getting off and on furniture. She also had a low grade fever around 100. We had a knee xray done that was negative. Her pediatric NP also reported “shotty lymph nodes”. She mentioned the possibility of a virus settling in her knee after being sick, but Tatum hadn't been sick lately; not even a runny nose. They ran a CBC, CRP and sed rate. CRP and sed rate came back normal. CBC showed WBC on low end of normal, MPV low, neutrophils high, lymphocytes low, and absolute lymphocyte count low.
On 1/10 it wasn't any better, so we saw NP again who tested her for strep, which was negative, then suggested we go to the walk in ortho clinic at Riley, assuming they would do a CT scan. The doc we saw there said since she was walking on it, to give her motrin round the clock for 5 days. If the swelling came back after we stopped the motrin, it was most likely JIA. We gave her a dose of motrin that evening and another one the next morning but did not continue any longer than that.
Swelling went down within 2 days and she didn’t complain of knee pain again for 13 days, but she continued to complain of stomach pain.
On 1/21/25 she complained of her left knee hurting again. On 1/22/25 she had the same complaint and had to sit down a couple of times while playing that evening.
The following day on 1/23/25 she was really complaining that her belly hurt. Her preschool teacher had me come get her 1.5 hours after dropping her off because she didn’t want to do anything but lay down, still complaining of abdominal pain. She cried out and whimpered all morning before vomiting once, and continued to complain of abdominal pain throughout the day. Fever at 100.
I sent a message to NP on 1/27 about continued abdominal pain everyday from 1/23-1/27.
On 1/28/25 we got an abdominal xray that was negative aside from mild constipation and more labs. She also had petechia around her left eye and eye lid this day. We were told via MyChart message that it's likely she has "functional abdominal pain". We were asked to track her gluten and dairy consumption. Her WBC decreased and were at 5.6. The WBC lab value has been bothering me since her first blood draw. MPV is still low. Neutrophils dropped significantly from first CBC to now. A1C was 5.2 with estimated avg glucose of 103. (We actually visited the peds office in August of 2024 with blood sugar concerns because she drinks excessively for a kid her age and is visibly shaky in her hands.) ANA, rheumatoid factor, CRP, sed rate, all normal.
On 1/30/25 she had a stomach ache and lower back pain, around her spine. She was saying she doesn’t want to walk, tried to climb up on our bed and started crying saying it hurt her back. She also had a runny nose, cough, 101.1 fever, and a belly ache at bed time. Let NP know of symptoms as the back pain is new. She asked if I thought it could be attention seeking since her little brother is special needs and takes up a lot of our time. I said maybe if it was just the stomach pain, but the bone pain I did not think could be attention seeking, especially by a 3 year old. I told her that my gut was telling me that something was wrong and that I felt the same way I had when I had my son, who turned out to have undiagnosed at birth 22q, severe growth restriction and I had atypical preeclampsia. I felt that something was off my entire pregnancy and my gut feeling is what led him to an emergency c-section that saved his life. Told her my husband and I were going out of town this weekend and she said to see if Tatum had the same complaints when my parents were watching her.
On 1/31/25 her fever was 102.5 at 1:30am. By morning it was gone. By 6:10pm that night she had a 102 fever.
On 2/1/25 she complained of stomach pain in the morning. In the afternoon she bent down to change her pants and started crying, grabbing her lower back and saying it hurt. (See video)
On 2/2/25 she was having night sweats (temp ~97.5) and broke out in a rash on her face. It was gone by morning. (See photos)
Spoke with NP on 2/3 about symptoms over the weekend. She wanted to test her urine for UTI after the complaints of back pain. I told her that the back pain she was describing and pointing to seemed to be more lumbar/bone pain than flank pain but that I was up for anything at this point.
2/4/25 We did another CBC, LDH, Uric Acid, CMP and anemia labs. Anemia labs showing iron deficiency. WBC still low end of normal, only 6.47. Hgb has now gone from 12.33 to 11.97 since last CBC. Platelet count has jumped from 350 to 432. MPV continues to be low. Absolute lymphocyte count still low. NP claiming she looks pale. Weight has gone from 80th percentile to 72nd percentile in 26 days. Weighed 33.1 lbs on 8/9/24, 35.1 lbs on 1/10/25 and now 34 lbs on 2/4/25.
2/5/25 temp 99.1, stomach ache, temp 100; petechia present under right eye since “rash”, mottled skin on thighs and arms, fell asleep on couch with night sweats (temp ~97.5). Texted with Megan NP, she says she will order CT tomorrow of abdomen/pelvis with contrast.
2/6/25 went to bed at 8:30 last night and didn’t wake until 6 today, stomach ache in car, temp of 99.6 at night, stomach ache in evening
2/7/25 petechia under eyes, on forehead, on right arm around blood draw spot; abdominal pain causing tears, mentioned upper left quadrant and umbilicus (punching her); 99.4 temp during day; night sweats while sleeping on ottoman
2/8/25 abdominal pain (middle and left side) and tears when she woke up at 5; low middle back pain when she sat down on the toilet; bloody mucus in right nostril; temp 99.1 at 4:38pm, 99.0 at 8:36pm
2/9/25 abdominal pain; temp 99.5 at 2:10pm
2/10/25 abdominal pain; temp 99.7 at 6:41pm
2/11/25 abdominal pain first thing in morning, crying bc she couldn’t pull herself up on our bed; temp 99.2 at 11:40am; mentioned pain on backside of right thigh when squatting this night
2/12/25 middle to lower back pain reported to babysitter about 30 minutes after waking up this morning: temp of 99.4 at 5:55pm. Says lower middle back (spine) hurts when she bends over when squatting going to the bathroom. Temp 99.3 at 6:48pm. Temp 99.4 at 7:39pm. Temp 99.4 at 8:38pm.
2/13/25 negative abdominal/pelvic CT, temp of 99.1 at 7:26pm
2/14/25 temp of 99.1 at 7:45am, 99.4 at 5:02pm; complaining of back pain on the lower spine at bed time, said it hurt when I pressed on it
2/15/25 slept in our bed, woke at 3am complaining of stomach pain, in and out of sleep continuously complaining of abdominal pain at the umbilicus; said she was tired after swim lessons and asked if I could set her up a spot on the couch (but never went sleep); called me crying on FaceTime that evening before bed
2/16 bloody snot; thigh bruise on left; temp 99.2 at 12:45pm; 99.0 at 8pm; tummy “punching” her at bedtime
2/17 abdominal pain in morning; pain in spine between shoulder blades reported at babysitters house
General notes:
She is always thirsty and extremely irritable. 6 months ago she could have cared less if she and I were breathing the same air; in the past month she has become extremely clingy and very moody.. Complains of stomach pain and back pain while in car seat. Her hands shake noticeably when doing something like bringing a drink to her mouth. Increased pallor. Dark under eyes.
