Kathy has posted the following messages about Fitz-Hugh-Curtis syndrome at: The Women's Health Forum ( http://forums.obgyn.net/womens-health/)
Her messages have been responded to by physicians, who donate their time to comment on some of the many messages which are posted at the Women's Health Forum.
1.)* FITZ-HUGH-CURTIS SYNDROME
On January 18, 2000, Kathy said: I AM SEARCHING FOR AN EXACT DEFINITION OF THIS SYNDROME. I HAVE LOOKED IN TABERS AND OTHER MEDICAL DICTIONARIES AND HAVE NOT BEEN ABLE TO FIND ANY THING. I AM NEW TO THE WEB AND AM HAVING DIFFICULTY FINDING ANYTHING HERE EITHER. THE ONLY THING I HAVE BEEN ABLE TO FIND ON IT IS A PICTURE OF ADHESIONS CAUSED BY ( OR IS? ) THE SYNDROME. I HAVE RECENTLY DISCOVERED THAT I HAD BEEN DIAGNOSED WITH THIS SYNDROME OVER A YEAR AGO AFTER HAVING SURGERY FOR A RUPTURED ECTOPIC PREGNANCY. I ALSO DISCOVERED FROM THIS SAME OPERATIVE RECORD THAT I WAS ALSO DIAGNOSED WITH CHRONIC PID. I WAS NEVER TOLD ABOUT EITHER OF THESE AND AM VERY CONCERNED AND CONFUSED. COULD THIS SYNDROME ALSO CAUSE AN ELEVATED SGOT? I WOULD GREATLY APPRECIATE ANY INFO YOU MAY HAVE ON THIS SYNDROME AND ON PID. THANK YOU
2.)* FITZ-HUGH-CURTIS SYNDROME
On January 18, 2000, Kathy said: ALL I HAVE BEEN ABLE TO FIND IS A PICTURE OF ADHESIONS CAUSED BY THIS SYNDROME. I HAD AN UNDIAGNOSED TUBAL PREGNANCY DECEMBER OF 98 THAT EVENTUALLY RUPTURED CAUSING LOSS OF MY TUBE AND OVARY. AFTER REQUESTING MY MEDICAL RECORDS OF THE SURGERY, A YEAR LATER, I DISCOVERED THAT I HAD BEEN DX AT THAT TIME WITH THIS SYNDROME AND CHRONIC PID. I HAD NEVER BEEN TOLD THIS IN THE PAST AND WAS TOLD AFTER THE SURGERY OF THIS. I AM VERY CONCERNED AND CONFUSED. I RECENTLY HAD MULTIPLE LABS RUN DUE TO C/O EXTREME FATIGUE, WEIGHT GAIN, AND AN ISOLATED INCIDENCE OF 3+ PITTING EDEMA TO BILATERAL LOWER EXTREMITIES. MY SGOT CAME BACK SLIGHTLY ELEVATED. COULD THIS BE CAUSED BY THIS SYNDROME? I AM HAVING A HEPATITIS PANEL DRAWN TOMORROW. ALSO, I AM HAVING SURGERY 2/4/00 TO REMOVE MY REMAINING OVARY THAT HAS ADHERED TO MY BLADDER AND IS CAUSING FREQUENT CYSTS. THE CAUSE OF THIS IS THOUGHT TO BE DUE TO SCAR TISSUE FROM THE RUPTURE AND SUBSEQUENT SURGERY. COULD IT ACTUALLY BE A RESULT OF THIS SYNDROME; AND IF SO HOW CAN THIS SYNDROME BE TREATED SO AS NOT TO CAUSE FURTHER DAMAGE? ANY INFO YOU MAY HAVE WOULD BE GREATLY APPRECIATED.
3.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 18, 2000, Harvey S. Marchbein, M.D. said: The classic definition of FHC syndrome is perihepatic adhesions secondary to PID. Now in English - for the rest of the peanut gallery: Adhesions near and on the liver, frequently are described as "violin string" adhesions from an extension of pelvic inflammatory disease up the right side of the abdomen to the area around the liver. The original description of FHC syndrome from PID was related to gonorrhea but we now know that chlamydia was probably the cause in most patients. It is sometimes spelled FitzHugh-Curtis.
4.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 18, 2000, Kathy said: Thank you for the info and I apologize for the shouting ( an added enlightenment, thank you! ). Could you also tell me what the symptoms of FHC syndrome are and are they present in all cases? I have had no symptoms and have never been DX with chlamydia or any other STDs and as of recent testing by my Infertility specialist, I still remian without any STDs. In fact, I have been symptom free other than chronic infertility. I was very surprized to read these diagnosis on the operative report. Also, is there treatment for this syndrome and is it curable? Thanks so much and again, sorry for the computer iliteracy!
5.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 19, 2000, D. Ashley Hill, M.D. said: Fitz-Hugh-Curtis syndrome is named after two doctors, Fitz-Hugh and Curtis. The "syndrome" designation is kind of a misnomer, because, in my experience, the majority of patients who have violin-string adhesions of the liver have no symptoms at all. Some, however, get pain when taking a deep breath, and I have had a couple of patients get mildly elevated liver function tests (like the SGOT you mentioned). If asymptomatic the adhesions do not need treatment. However, they will not go away on their own.
Possible causes include infection like ruptured appendix, gonorrhea, chlamydia, pelvic inflammatory disease from any source. About 75% of PID is from either gonorrhea or chlamydia, but 25% are from endogenous(from your body) bacteria. It sure sounds like somewhere in your past you developed a rip-roaring pelvic infection that damaged your tube(s) and caused liver adhesions. You will probably never know when that was, since it could have been your own bacteria, or chlamydia that was accidentally treated with antibiotics for some other reason (like a cold or sinusitis). Regardless, if the adhesions are not bothering you, I would be reluctant to suggest any intervention.
I think I have a picture of this on my web page, but I'm not sure. Try http://home.mpinet.net/dahmd and go to the photos section.
6.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 19, 2000, Kathy said: Since what ever I had was apparently treated at one point and I now no longer have what ever it was that caused it. Can I still continue to develop adhesions even after treatment? Or, could the the adhesion of the remaing ovary be caused by surgery I had last year??
7.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 19, 2000, D. Ashley Hill, M.D. said: Either is possible, and you will never know which one was the culprit. If the pelvic organs are inflammed it's possible for adhesion to occur at any time. There is nothing that we know of to prevent this. Sadly,the female pelvic organs have a propensity towards adhesion formation. While laparoscopic surgery can sometimes cause adhesions, this is less likely than adhesion formation from the illness itself.
I hope the surgery goes well and you end up with an uneventful pregnancy!
8.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 20, 2000, Kathy said: Thank you again Dr. Hill for taking the time to answer my questions and most of all, for your kindness. I have gotten more answers from you than I have from anywhere else. Because of this I am feeling much better about, and knowledgeable of what is going on with my own body. I'm not saying that I like the situation, but just having answers is very comforting! Thank you again for your kindness and words of encouragment. I did visit your web site and it is great. I was unable to find a photo of the syndrome, but I did find other great educational info and photos. You must be a very generous person to take such time from your obviously busy schedule to help people such as myself. You obviously understand and care about the turmoil that people like myself feel when they have lack of knowledge of their own bodies. For this, I am very grateful. I'm sure I will be visiting your website again!
9.)* Re: FITZ-HUGH-CURTIS SYNDROME
On January 20, 2000, Robin said: Excellent description of Dr. Hill!!!! Couldn't have said it better myself!!!! I know I speak for many when I say how deeply Dr. Hill was missed when he wasn't on this forum. I'm just so glad to see him back!!!!!