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 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
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.
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
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
- Pancytopaenia with macrocytic anaemia
- Leucopenia with macrocytic anaemia
- Thrombocytopenia with macrocytic anaemia
- 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.
On the basis of the present symptoms and my observations I prescribed Calc phos 6x /bd/3 months.
Her dental structure changed a lot after menstruation, and herwhole skull grew in size and the features changed.
Editor’s note: Dr. Mehta presented this case at the Kent Memorial Lectures by SDHA in Delhi in 2016.