Vascular Foot Issues Remain Undiagnosed in 35-Year-Old Patient

by Faisal Meghani

I am 35-years-old, built small and skinny— from southeast Asia. It started with a fungus around February 2015 on my right foot about the fourth and fifth toe. It became worse and worse over time even when applying over-the-counter topical creams. I went to my primary care physicians and he gave me a prescription topical cream but that did not help. I went to go see an urgent care clinic doctor who saw my feet and legs and noticed major black/blue spots indicating blood circulation issues. I went to go see a vascular surgeon who did an angiogram and angioplasty on my left leg. Then I went to see a rheumatologist who put me on 20 mg of Prednisone in the beginning and then tapered down to 5 mg.

Since then, I have seen 2 more rheumatologists, 3 podiatrists, 2 vascular surgeons, and 1 cardiologist and no one can come up with a diagnosis. Both my feet are wrapped up in 2 layers of gauze and one ace wrap so I can barely walk. I have 2 toes amputated on the right foot and 1 toe on the left foot.

Recently, I found out that my liver enzymes are double than normal so I will need to get a liver biopsy done soon. Now, first week of July 2016, and there is no diagnosis for what is going on.