Season 3
Episode 1 - Meaning
Brief Plot Summary
House is back after being shot several months earlier and he decides to take two cases. One is a yoga instructor named Caren who claims that she is paralyzed and the other is of a man named Richard who had brain cancer and is now completely paralyzed and then drives his wheelchair into the water, which everyone believes means suicide. House tries to burn Caren's foot and when she moves it, he proclaims she was faking, and he also orders a surgery for Richard to ease the pain caused by muscle atrophy. Caren is now struggling to breathe and she has pleural effusion which indicates a heart problem. However, he thinks that the paralysis could have been a delusion which could indicate a neurological problem and he orders and exploratory surgery of her spine. However, he notices that her toe nail is corrugated and splintered. He deduces that she had scurvy, a disease that sailors used to get. When House hears a grunt from Richard, he declares that he spoke and tells the team to write all the symptoms that he had over the past eight years. He thinks it could be a pancreatic cyst, but the endoscopy reveals nothing. Suddenly, after stepping in cold water after a run, House realizes that he could have had hypothalamic dysregulation and wants to give Richard a shot of cortisol. When Dr. Cuddy gives him the shot, Richards starts walking again.
House is back after being shot several months earlier and he decides to take two cases. One is a yoga instructor named Caren who claims that she is paralyzed and the other is of a man named Richard who had brain cancer and is now completely paralyzed and then drives his wheelchair into the water, which everyone believes means suicide. House tries to burn Caren's foot and when she moves it, he proclaims she was faking, and he also orders a surgery for Richard to ease the pain caused by muscle atrophy. Caren is now struggling to breathe and she has pleural effusion which indicates a heart problem. However, he thinks that the paralysis could have been a delusion which could indicate a neurological problem and he orders and exploratory surgery of her spine. However, he notices that her toe nail is corrugated and splintered. He deduces that she had scurvy, a disease that sailors used to get. When House hears a grunt from Richard, he declares that he spoke and tells the team to write all the symptoms that he had over the past eight years. He thinks it could be a pancreatic cyst, but the endoscopy reveals nothing. Suddenly, after stepping in cold water after a run, House realizes that he could have had hypothalamic dysregulation and wants to give Richard a shot of cortisol. When Dr. Cuddy gives him the shot, Richards starts walking again.
Diagnosed Disease: Scurvy & Hypothalamic Dysregulation - Scurvy is a disease that is brought on by a vitamin C deficiency and has been seen frequently in sailors due to a diet without any food containing vitamin C. Hypothalamic Dysregulation can be caused by a host of conditions or procedures that have affected the hypothalamus in the brain, which controls temperature, salt and water balance, weight and appetite, growth, adrenal glands, and the thyroid gland.
SymptomsScurvy - Lethargy, shortness of breath, bone pain, poor wound healing, edema, muscle pain (myalgia), fever, neuropathy, convulsions
Hypothalamic Dysregulation - whole host of symptoms that are very diverse due to the various organs controlled by the the hypothalamus. |
CausesScurvy is caused by a vitamin C deficiency and it causes weakness in collagen which can cause the bleeding.
Hypothalamic Dysregulation can be caused by a surgery, injury, genetic condition, virus, or other cause that could affect the hypothalamus in the brain which controls the pituitary gland and other functions. |
TestsScurvy is usually diagnosed based on the symptoms but a blood test can also be done.
Hypoothalamic Dysregulation can be seen through blood tests that reveal lower levels of hypothalamus regulated hormones. |
Treatment/CureFoods and drinks high in vitamin C should be consumed and this will usually reverse the effects.
The missing hormone can be given as treatment. |
Source Links: Scurvy Wiki, NIH Page
Episode 2 - Cane and Able
Brief Plot Summary
A seven year old boy, Clancy, is admitted with rectal bleeding and hallucinations. The team believes it's a bleeding disorder, but the tests keep switching between positive and negative. Noticing a patch of cells in his heart that aren't contracting, House finds that these cells have different DNA than the rest of his body. They tag these cells with antibodies and remove them; however, he continues to suffer from seizures and hallucinations.
A seven year old boy, Clancy, is admitted with rectal bleeding and hallucinations. The team believes it's a bleeding disorder, but the tests keep switching between positive and negative. Noticing a patch of cells in his heart that aren't contracting, House finds that these cells have different DNA than the rest of his body. They tag these cells with antibodies and remove them; however, he continues to suffer from seizures and hallucinations.
Diagnosed Disease: Chimerism - Condition in which an organism is composed of 2 or more sets of unique DNA. This can occur in humans during fertilization when two embryos fuse together into one and then grow into one person.
SymptomsIn the episode, the symptoms included elevated blood pressure, seizures, and hallucinations from cells in his leg, brain, heart, and eye. Depending on where the chimeric cells are located, symptoms can change.
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CausesIn vitro fertilization can elevate chances of embryos fusing together because 6-7 embryos are used at once to make sure fertilization occurs.
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TestsChimeric Cells generally do not function properly and thus can be identified via patient symptoms. Once identified, the unique DNA allows for the creation of fluorescent antibodies to tag these cells.
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Treatment/CureThe chimeric cells must be taken out if they are affecting major organs.
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Episode 3 - Informed Consent
Brief Plot Summary
Dr. Ezra Powell was admitted after he collapsed in his lab while studying rats due to fluid build-up in his lungs. After a stress test rules out the heart, the team focuses on the lungs and does a lung biopsy. He then realizes that the patient has lost sensation in his right arm and right leg meaning that his nerves are being affected as well. Finally, House has a revelation and deduces that Powell has amyloidosis subtype AA, which is terminal.
Dr. Ezra Powell was admitted after he collapsed in his lab while studying rats due to fluid build-up in his lungs. After a stress test rules out the heart, the team focuses on the lungs and does a lung biopsy. He then realizes that the patient has lost sensation in his right arm and right leg meaning that his nerves are being affected as well. Finally, House has a revelation and deduces that Powell has amyloidosis subtype AA, which is terminal.
Diagnosed Disease: Amyloidosis - Accumulation of amyloids, which are insoluble fibrous proteins arising from inappropriate protein folding, in various parts of the body.
SymptomsSymptoms can vary drastically depending on where in the body these proteins build-up, but generally associated with neuro degenerative disorders and inflammation. Organ failure is common is the severe forms as the protein deposits inhibit proper function.
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CausesCan be inherited or genetic. Protein deposits due to improper protein folding result in the deposits. There are also several different types of amyloidoses
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TestsCongo red staining is a histological test that is essential to confirm an amyloidosis diagnosis. In the test the patient's cells are stained with Congo red to identify whether amyloids are present. Seen below, the red-orange represents amyloid deposits.
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Treatment/CureThere is currently no cure for amyloidosis; however, there are specialized treatments to aid in preventing the amyloid build-up. If the build-up isn't stopped organ transplants and drug could be needed to extend the patient's lifespan.
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Episode 4 - Lines in the Sandbox
Brief Plot Summary
Adam is severely autistic and is admitted when he begins to gag as if choking. The team begins by testing for allergies. After MRI's and blood tests yield no results, Adam coughs up more fluid from his lungs. A stool sample and lung biopsy also come up negative. Interestingly, a lymph node biopsy shows reveals that there are liver cells in his lymph node. It seems that jimson weed, could be responsible, but when Adam points to the sandbox, House tries to look for another answer. Adam's eyeball then rolls back into its socket, prompting preparation for surgery to remove a possible tumor. House stops them just in time to look into Adam's eye to find roundworms in his eye from the raccoon stool he ingested while eating sand from the sandbox.
Adam is severely autistic and is admitted when he begins to gag as if choking. The team begins by testing for allergies. After MRI's and blood tests yield no results, Adam coughs up more fluid from his lungs. A stool sample and lung biopsy also come up negative. Interestingly, a lymph node biopsy shows reveals that there are liver cells in his lymph node. It seems that jimson weed, could be responsible, but when Adam points to the sandbox, House tries to look for another answer. Adam's eyeball then rolls back into its socket, prompting preparation for surgery to remove a possible tumor. House stops them just in time to look into Adam's eye to find roundworms in his eye from the raccoon stool he ingested while eating sand from the sandbox.
Diagnosed Disease: Parasitic Raccoon Roundworm - Baylisascaris procyonis is the most common species of raccoon roundworm and is very rare to contract in humans.
SymptomsIn most animals, symptoms include a heavy attack on the central nervous system along with intestinal infestation. In the episode, the worms penetrated the lungs cause the effusions, killed cells in the liver, and infected the eye.
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CausesEating raccoon stool, uncooked animal meat, or unclean water is the only way to contract this specific parasite.
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TestsThe worm can be seen in the eye. Interestingly enough, it can't be spotted in the stool; only the egg can be.
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Treatment/CureAnti-parasitic drugs are needed on a regimen to ensure that all of the parasites are killed.
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Source Links: CDC, Michigan Department of Natural Resources