Clinical Cases

A Case of MRKH syndrome – Uterine Agenesis

Mini Mehta
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Dr. Mini Mehta presents a case of MRKH syndrome.

Mayer –Rokitansky – Kuster – Kauser (MRKH) Syndrome is a disorder that occurs in females and mainly affects the reproductive system. This condition causes the vagina and uterus to be underdeveloped or absent. Affected women usually do not have any menstrual periods due to absent uterus.

This is a case of a 14yr old girl who was on my treatment for her recurrent complaints of fever, headache and weakness since her childhood. She had great improvement in her health and stamina with homoeopathy. While treating her for her acute problems over the years once I got to know through investigations that she had no uterus development at the age of 15, also with some Thalassemia-like symptoms.

With homoeopathy her uterus developed and she started menstruating within 5-6 months of treatment and also her blood values became perfectly normal along with the usg.  She had a complete face and body transformation with the homoeopathic treatment.

Last but not the least a proper diet schedule and urinary output chart was maintained which played an important role.

The patient took “Five Phos” in water as a supplement. Five Phos is a combination of Schussler cell salts containing  Calcarea phosphorica 6x, Ferrum phosphoricum 6x, Kalium phosphorcium 6x, Magnesia phosphorica 6x and Natrum phosphorica 6x.  I also put her on beetroot juice, apple juice and anoil free and spice free diet.

Now she along with her family are my regular patients .

CASE IN DETAIL

One day in Nov2013 she came to my clinic with severe pain in abdomen, headache, thirst, restlessness, vomiting, and general burning sensations. On investigation her HB was low and she had raised bilirubin levels

I prescribed arsenic 30/every 15 minutes  (10 drops ars 30 in 150ml water). As she improved I gave it less often.  She responded well and her LFT was normal in 15 days and her symptoms were relieved.

She responded well and her LFT was normal in 15 days and her symptoms were relieved.

As she recovered from the jaundice she reported some scaly thick lesions on the nape of her neck and forehead, abdomen, arms and legs. When I saw them I could see that it was a very bad icthyosis.

She was already on arsenic 30 one teas spoon /BD

After retaking the case I prescribed Psorinum 30/1 dose stat on tip of the tongue. I prescribed Psorinum because I smelled the odor of a dead animal as soon as she sat beside me. I asked her about the odor and she said she was sweating a bit more now days.  Her urine was also very offensive and she had a greasy face.

As the skin started clearing, it seemed to me as if she was growing weaker and losing flesh.  At the weekly OPD I saw that she was so thin, that I could count the vertebrae in her spinal column.

Now her skin was fine but she kept consulting me for recurrent cold, cough and mild headache.

6th March 2014

It was going on like this when suddenly one Monday evening her father rushed to  my clinic carrying her in his arms, as she was unable to walk, had severe headache (more in occipital area).  She lay down in my clinic as she was unable to hold her head up and was worse <bending.

Bodyache especially back, hands, legs and feet joints.

Pain in abdomen with hot burning urine.

Patient’s Status

Patient was fully conscious and well oriented of the time and surroundings.

Face –pale , sunken with swelling more about eyes.

Mental Generals – irritable with the family except the fat

Very cooperative and hopeful with me

Physical generals

Appetite –   no appetite, nausea with smell of cooking food

Vomiting whatever she eats

Thirst              normal but vomits water also

Tongue           clean moist and slight trembling

craving           for cold drinks or anything cold

Aversion        smell of food cooking

Stool               loose, black one day ago, no stool since morning

Urine              scanty, chemical like smell and brown

Thermal reaction   hot

Sleep               feels like resting all the time

Sleepy all the time.  Takes small naps, sleeps on left side

Menstruation         menarche not approached

This was too much extraction of symptoms in an acute case when patient is bearing so much pain.

Basis of my prescription

Joint pains-hands and foot

Brown stinky urine

Rx:  acid benzoic 30/every 15 min (1 teaspoon from one cup of water)

 1st follow up  –  10/03/14

Next morning the pain was much better so I asked her to continue the same treatment 2 hourly for 3 days.

Investigations advised

Heamogram,LFT,KFT,

 2nd    follow Up after 3 days 13/03/14

Pains better in joints, much better in hands

Urine increased in quantity, less offensive but it is dark as ink.

Backache >rest and pressure

Pain in anterior aspect of thigh running down to toes with some numbness in the toes.

Lower extremities cold to touch bilateral

Pain abdomen slight all the time

Nape of neck still so weak and painful that she was unable to sit upright

Eye watering with so much weakness that she could not read the fine prints in the book

On examination of both eye with a light I noticed that only the left pupil  contracted.

Now the most troubling symptom was that she was unable to eat inspite of appetite, due to nausea from the smell of cooked food.

Extremely irritable with the family

On the basis of nausea for odor of food, pain thighs goin down toes, dark urine and unequal pupil contraction I prescribed Colchicum autumnale.

RX:   Colchicum autumnale 30/half hourly /1 teaspoon (from a mixture of 10 drops of colchicum/200ml water) for three days

After three days she came and reported that the nausea was now controlled.  She could eat a little but the pain in back and abdomen was more gripping in nature and travelling down to thighs and legs > by pressing hard.

She was very irritable according to attendants.

I changed the remedy to Colocynth 30 every 15 minutes and told them to report in the evening.  In the evening patient reported that she was 60 percent better.

According to the investigations:

  • Hb 7.8
  • She had pancytopenia with macrocytic anaemia
  • LFT was normal
  • KFT Normal
  • Montaox test – normal
  • There was no uric acid raised levels

3rd Follow up   – 16/04/14

She became so thin she looked skeletal. She was 60 percent better but very weak, could hardly walk. She had constant pain in the back so we got a usg done.

 Her USG impression was

  • Liver showing heterogenous echo pattern
  • Contracted right kidney with grade- 3rd nephropathy
  • Multiple mesenteric lymph nodes
  • Thickened small bowel loops s/o enteritis
  • NO UTERINE STUMP VISUALISED

After getting the confirmation with the MRI report it was concluded that she was suffering from MRKH As per the MRI – small atrophic right kidney, hypertrophied left kidney

hypolinear bands seen at the place of uterus, ovaries  visualized

 

4th follow up25/04/14

She developed UTI with fever and pain

 Rx : Apis30, terebinthena oleum 

She was relieved

Again after 10 days she got fever 101F-102F, chilliness, burning  pains

Rx  Arsenic alb 30/every 15 min from a cup of water

5th follow up

04/05/14

After three days she developed fever coming in the early evening 4-8pm

Now she feels like eating some sweet and could eat only warm food.

During fever her right foot was hot and the left cold.

Rx  Lyc 0/1 -2hourly  /3days

She was very much better on the Lyc.

We continued Lyc in LM for weeks but she wasn’t gaining weight and haemoglobin was low.   

Her blood pictures suggested

  1. Pancytopaenia with macrocytic anaemia
  2. Leucopenia with macrocytic anaemia
  3. Thrombocytopenia with macrocytic anaemia
  4. Macrocytic hypochromic anaemia

 

  

During a follow up her father told that one of his sisters died of thalassemia at the age of 19 despite treatment and blood transfusions.

Then I asked them to get Hb electrophoresis done

Result was slightly raised  hbF

As she was much relieved in her pains the family wished to continue with my treatment only.

She did not approached menarche due to undeveloped uterus and also she was representing with her blood picture a kind of beta thalasemia and the thalaesmic also face puberty issues due to improper functioning of the pituitary gland in them.

I prescribed pituitary 3x /3-4doses/ od  /alternate days

She was much improved in strength as if her voltage supply to the body was doubled.

There on we continued symptomatic treatment with Lyco in LM potency or sometimes with some other remedy for any acute complaint Eg.:

Cactus and Kali carb for backache and pain in abdomen

Her Hb levels started improving and one day she reported bleeding per vaginum. It started on August14 and continued for 6 days without any pains or other complaints.

After the bleeding was over we got a USG.  It showed right sided chronic renal disease.

Uterus and ovaries were visualized normal in size and pattern.

Thereafter she started menstruating and gained a good height and weight gradually.

About the author

Mini Mehta

Mini Mehta

Dr. Mini Mehta was born in New Delhi in 1985. She completed her BHMS from Baksons Homoeopathic Medical College in 2008 and has run her own private practice for the last eight years - Karishma Homoeopathic Clinic. She is always trying to learn more and so attends as many seminars as she can. She gained clinical and I.P.D experience under the guidance of Gynaecologists, Cardiologists and other senior homoeopaths.

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3 Comments

  • Excellent case: shows how deep pathology can be treated and how completely the body can heal itself. Because I cannot prescribe tests as a Homœopath in my country, I am often working blind. This case illustrates with follow-up medical tests, the changes that occur on the proper handling of a case. I have heard Homœopaths mention the changes in the structure of the face on the right prescription, but it is the first time I have seen it illustrated so clearly. Thank you.

  • The patient is really fortunate enough to get normal. This type of uterine agenesis rarely responds with the homeopathic medicine, but it has happened. It is the unique news for the entire medical world.
    My sincere thanks and good wishes go to the young doctor.
    From time to time she changes the medicine and gets the good result.
    It would be more scientific if she presents the repertorial analysis of her prescriptions.
    I congratulate Dr. Mini Mehta for her splendid case presentation.
    I advice her to go ahead with the work of such rare and almost incurable cases.
    Best wishes.