Season 5
Episode 5 - Lucky Thirteen
Brief Plot Summary
Spencer, a girl Thirteen slept with, has a seizure. They get a bone marrow biopsy and search Thirteen's apartment for drugs. She then crashes as her heart rate spikes. They do a CT scan on her kidneys to find any possible calcification and perform surgery to remove it. Follow the surgery, Spencer can no longer breathe and they intubate. Another CT shows lung cysts. A biopsy reveals that she appears to have Lymphangioleiomyomatosis, a disease which will progressively replace her normal lung tissue with cysts. She then develops anemia. They get her consent to do a bone marrow transplant. House then asks Thirteen if Spencer cried after hearing the diagnosis. He then realizes that the true cause of her illness is Sjögren's syndrome.
Spencer, a girl Thirteen slept with, has a seizure. They get a bone marrow biopsy and search Thirteen's apartment for drugs. She then crashes as her heart rate spikes. They do a CT scan on her kidneys to find any possible calcification and perform surgery to remove it. Follow the surgery, Spencer can no longer breathe and they intubate. Another CT shows lung cysts. A biopsy reveals that she appears to have Lymphangioleiomyomatosis, a disease which will progressively replace her normal lung tissue with cysts. She then develops anemia. They get her consent to do a bone marrow transplant. House then asks Thirteen if Spencer cried after hearing the diagnosis. He then realizes that the true cause of her illness is Sjögren's syndrome.
Diagnosed Disease: Sjögren's Syndrome - Chronic autoimmune disease that causes the white blood cells to destroy the exocrine glands such as salivary and lacrimal glands.
SymptomsGeneralized dryness, dry eyes, no tears, dry mouth. Can affect other organ systems which explained her other symptoms
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CausesAutoimmune with genetic and environmental factors leading to its onset.
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TestsBlood tests and tear functionality tests are used to test for the condition. Biopsy can be done to visualize any lymphocytic infiltration and blockages.
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Treatment/CureThere is no cure or direct course of treatment so treatment is for symptom relief.
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Episode 6 - Joy
Brief Plot Summary
The episode starts with Jerry losing multiple hours in the day as is shown by his inability to remember how he ended up in some places. They find that the patient sleepwalks and decide to follow him. They find that he buys cocaine. Testing the cocaine reveals it's laced with lactose. Treatment for lactose intolerance doesn't help. During an examination, his kidneys begin to fail and he start to sweat blood. They do a bone marrow biopsy to test for leukemia. When they ask his daughter to donate a kidney, her monotonous response suggests she is sleepwalking as well. A conversation with Jerry reveals they are from Middle-Eastern decent. House realizes that they have Familial Mediterranean Fever, which explains anhedonia, vasculitis, and kidney failure.
The episode starts with Jerry losing multiple hours in the day as is shown by his inability to remember how he ended up in some places. They find that the patient sleepwalks and decide to follow him. They find that he buys cocaine. Testing the cocaine reveals it's laced with lactose. Treatment for lactose intolerance doesn't help. During an examination, his kidneys begin to fail and he start to sweat blood. They do a bone marrow biopsy to test for leukemia. When they ask his daughter to donate a kidney, her monotonous response suggests she is sleepwalking as well. A conversation with Jerry reveals they are from Middle-Eastern decent. House realizes that they have Familial Mediterranean Fever, which explains anhedonia, vasculitis, and kidney failure.
Diagnosed Disease: Familial Mediterranean Fever - A hereditary inflammatory disease
SymptomsOccur in different types of attacks, including chest pain, abdominal pain, joint pain, and fever in most cases.
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CausesGenetic disorder caused by mutation in the MEFV gene that encodes for pyrin.
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TestsA highly sensitive test for this disorder is metaraminol provocative test (MPT). A positive diagnosis is made if the patient suffers an attack within 48 hours of administration.
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Treatment/CureColchecine markedly improves quality of life by significantly reducing the onset of attacks (exact biochemical mode of action is unknown). NSAIDs can also be used to lower the inflammation.
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Source Links: Wiki, Mayo Clinic
Episode 7 - The Itch
Brief Plot Summary
An agoraphobic man is ill but refuses to be treated and remains in his house for treatment. The team goes to find toxins in his house, but they find none. When House bring in some people to set off his phobia, the patient has severe abdominal pain. They decide to operate on him to remove the bowel obstruction. When he crashes, they shock him back to rhythm but he still has bradycardia. They finally realize he has lead poisoning from the leftover bullet fragments of a 7-year-old shooting.
An agoraphobic man is ill but refuses to be treated and remains in his house for treatment. The team goes to find toxins in his house, but they find none. When House bring in some people to set off his phobia, the patient has severe abdominal pain. They decide to operate on him to remove the bowel obstruction. When he crashes, they shock him back to rhythm but he still has bradycardia. They finally realize he has lead poisoning from the leftover bullet fragments of a 7-year-old shooting.
Diagnosed Disease: Heavy Metal Poisoning (lead poisoning) - Causes several types of symptoms depending on dosage and location. The patient had constipation, neuropathy, and seizure as his main symptoms. Look at S4Ep6.
Source Links: Wiki
Episode 8 - Emancipation
Brief Plot Summary
A 16-year old girl is admitted after she starts to choke on blood in her lungs. They believe it could be a drug issue and do an echo to check for heart problems. Kutner puts her on steroids after believing that she didn't do drugs and she has a psychotic break. They do an FMRI to check for any possible arterial spasms that set off the delirium. Her kidneys begin to fail and after chelation for arsenic poisoning, she begins seizing. They find legions in her brain and her condition worsens. Since arsenic is used to treat acute promyelocytic leukemia, it was keeping the leukemia in check.
A 16-year old girl is admitted after she starts to choke on blood in her lungs. They believe it could be a drug issue and do an echo to check for heart problems. Kutner puts her on steroids after believing that she didn't do drugs and she has a psychotic break. They do an FMRI to check for any possible arterial spasms that set off the delirium. Her kidneys begin to fail and after chelation for arsenic poisoning, she begins seizing. They find legions in her brain and her condition worsens. Since arsenic is used to treat acute promyelocytic leukemia, it was keeping the leukemia in check.
Diagnosed Disease: Acute Promyelolcytic Leukemia - Cancer of the white blood cells in which there is an abnormal buildup of promyelocytes
SymptomsAnemia, fatigue, fever, weakness, dyspnea
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CausesCharacterized by a chromosomal translocation of the retinoid acid receptor-alpha gene on chromosome 17.
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TestsPathologic examination of a bone marrow biopsy and gene sequencing to test for the translocation are both ways to test.
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Treatment/CureOne of the most treatable forms of leukemia. Treated with all-trans retinoid acid and sometimes also with arsenic. Unlike most therapies, the ATRA allows for maturation of the immature promyelocytes.
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Source Links: Science Daily, Cancer.gov
