|Diagnosis||Familial Mediterranean fever|
Samantha’s mother died in an automobile accident when Samantha was four.
Samantha arrived home from school and found that her father had no idea what time it was, thinking she had just left for school when she had been away for over eight hours. She later asked her father what was wrong, and he was so confused he agreed to go to the hospital. Apparently, no time had passed for him since 4:30 that afternoon.
Samantha accompanied her father to the hospital. When House’s team found mold in their house, Samantha was tested for exposure, but insisted that she felt fine. Dr. Hadley found very little in their house, and asked Samantha what interests she had. She said she just went to school and her father worked and lived at home. Dr. Hadley asked her about the effect of her mother’s death, and Samantha replied that she didn’t remember her mother much and she didn’t get what the “big deal” about death was.
Dr. Hadley reported to Dr. Foreman that Samantha’s physical health was excellent but she was worried about her mental state.
When her father’s condition started to deteriorate, the doctors realized he would need a kidney transplant. Dr. House wanted to try to transplant one of Samantha’s kidneys, but his team reminded him that as a minor, they would need Dr. Cuddy to approve the procedure.
However, Dr. Cuddy was overseeing an emergency Cesearean section of her adopted daughter to be and Dr. House couldn’t get her attention. After the surgery was successful, Dr. Cuddy turned her attention to Dr. House’s request.
Dr. Cuddy spoke with Samantha about the risks of the transplant procedure. Samantha said she understood the risks of living with one kidney and still wanted to proceed with the transplant. However, Dr. House noted Samantha has a remarked lack of affect when she agreed. He realized that Samantha was sleepwalking and was suffering from the same condition as her father. He realized that a transplant would be pointless as the new kidney would fail as well. Dr. Taub tried to argue that Samantha’s sleepwalking was unrelated to her father’s sleepwalking, but Dr. Hadley reported that Samantha was also sweating blood just like her father as well.
They realized the problem had to be genetic as they had ruled out toxins and infections, but Dr. Kutner pointed out the symptoms could be caused by any of a dozen conditions and the necessary genetic tests would take at least a week. Dr. House told them to start testing anyway.
However, Dr. House finally realized that in addition to their common symptoms of bleeding, insomnia and kidney failure, both patients were exhibiting anhedonia. He rushed back to their room and announced that he had just figured out what they had and they were both going to be fine. He noted once again that they had little or no reaction to that announcement when they should have been showing happiness. Dr. Foreman noted the most common cause of anhedonia was schizophrenia, but at that point Dr. House asked Jerry what his real last name was. He finally admitted he had changed if from Hamood after the 1991 Iraq War. With a Mediterranean extraction, Familial Mediterranean fever was a far more likely diagnosis than schizophrenia. Dr. House informed them that the prognosis was poor after sweating blood started, but ordered them started on colchicine and melphalan. Dr. Foreman noted that given Jerry’s poor kidney function, colchicine would permanently damage them if he didn’t have Familial Mediterranean fever. Dr. House ordered the therapy in any event.
A few days later, both Jerry and Samantha were feeling better and started smiling and laughing. They planned again to transplant one of Samantha’s kidneys into her father.