Teen diagnoses her own disease in science class
During an Advanced Placement class in Histology, Jessica Terry from Sammamish, WA found a granuloma in an intestinal biopsy. The amazing part is that she had borrowed her own slides from her pathologist. According to CNN who picked up the story yesterday, June 11, there were no answers. However, in the video excerpt she describes being told she had colitis.
Teen diagnoses her own disease in science class
When evaluating an "intestinal" biopsy for a young person with chronic abdominal pain, you would be looking for signs of colitis such as active inflammation (such as cryptitis or crypt abscesses), chronic architectural changes, and granulomas. These can come in the form of "microscopic colitis" which is basically their way of saying they didnt see anything on the colonoscopy. You also have to keep your eye out for dysplasia, of course.
I feel sorry for the pathologist in this story, because it is all our worst nightmare, to be smeared in the media without being given the opportunity for defense. However, I would also like to know the whole story, because I have a feeling they are leaving something important out here.
Questions:
1. Why after so many years was only one colonoscopy done and only one biopsy?
2. When was that biopsy taken, what was the history given to the pathologist, and was it followed up by another biopsy later?
3. It sounds like she was told she had colitis, even if no granulomas were seen, she should have been worked up appropriately.... did this happen?
4. Did her primary care doctor ever refer her to a GI specialist?
5. Family history of Crohn's?
The way this story was written is fodder for those who wish to badmouth all doctors in general. However, us doctors would like to gather all the facts before going off of hearsay, then find out how this was missed so it doesnt happen again - Quality Assurance.
Here is a link to a good lecture I found somewhere on the great world wide web.
GI Mucosal Biopsy Lecture
Teen diagnoses her own disease in science class
When evaluating an "intestinal" biopsy for a young person with chronic abdominal pain, you would be looking for signs of colitis such as active inflammation (such as cryptitis or crypt abscesses), chronic architectural changes, and granulomas. These can come in the form of "microscopic colitis" which is basically their way of saying they didnt see anything on the colonoscopy. You also have to keep your eye out for dysplasia, of course.
I feel sorry for the pathologist in this story, because it is all our worst nightmare, to be smeared in the media without being given the opportunity for defense. However, I would also like to know the whole story, because I have a feeling they are leaving something important out here.
Questions:
1. Why after so many years was only one colonoscopy done and only one biopsy?
2. When was that biopsy taken, what was the history given to the pathologist, and was it followed up by another biopsy later?
3. It sounds like she was told she had colitis, even if no granulomas were seen, she should have been worked up appropriately.... did this happen?
4. Did her primary care doctor ever refer her to a GI specialist?
5. Family history of Crohn's?
The way this story was written is fodder for those who wish to badmouth all doctors in general. However, us doctors would like to gather all the facts before going off of hearsay, then find out how this was missed so it doesnt happen again - Quality Assurance.
Here is a link to a good lecture I found somewhere on the great world wide web.
GI Mucosal Biopsy Lecture
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