All In (House)

House (TV series) episode
episode_name = All In
episode_no = HOU-217
airdate = April 11, 2006
writer = David Foster
director = Fred Gerber
guest_star = Laura Allen as Sarah
Mackenzie Astin as Alan
Michelle Harrison as Nicole
Daylon Reese as Michael Carter Page as Ian


season = 2
diagnosis = Erdheim-Chester disease

All In is the seventeenth episode of the second season of "House", which premiered on the FOX network on April 11, 2006.

Plot

During a field trip in a museum exhibit about the human body, 6-year old Ian Allstand is found to have bloody diarrhea. Meanwhile, at charity Casino Night at Princeton-Plainsboro, House, Wilson, and Cuddy are engaged in a game of poker when Cuddy receives the news about her new patient. She dismisses it as dehydration and gastroenteritis, but House, recognizing the symptoms, decides to drop out of the game and take the case behind her back.

After testing Ian's coordination and brain function, House discovers Ian has Ataxia and realizes Ian has the same disease as a former patient from 12 years ago, 73-year old Ester (misspelled 'Esther' by House) Doyle, who died under House's care and was never correctly diagnosed. House then drags Cameron, Foreman, and Chase out of the party to perform a differential diagnosis. Drawing up a list of all of Ester's symptoms, House is able to predict what will happen to Ian next, as well as how long it will take him to get there.

House first suspects it is Erdheim-Chester disease and orders a colonoscopy, but tests are negative. House, knowing the next symptom that will develop is kidney damage, orders a kidney biopsy. However, they are too late: bloody urine proves kidneys are already far too damaged to be saved. The team is forced to do another differential diagnosis, however many of the diseases proposed, House already tested for 12 years ago.

Next the team postulates it is lymphoma and tries more tests. To keep Cuddy busy and off the case, House calls Wilson and has him stall her in the poker game. However, tests are negative for lymphoma. Unable to think up what disease afflicts the two people, House orders immediate treatment to protect Ian's liver, which was the next symptom Ester developed. His plan succeeds and Ian does not develop liver damage, but instead skips the next two symptoms and develops respiratory failure.

Thinking it could be cancer, House includes Wilson into the differential. Wilson suggests Kawasaki disease, but before the team begins tests, they discover a mass in his heart. Postulating that Ian, being younger than Ester, has a stronger immune system and can last longer while under assault from this unknown disease, House performs a heart biopsy on Ian.

The biopsy induces cardiac arrest in Ian, prompting an enraged Cuddy to pull House off the case and ban him and his team from performing any more tests on Ian. However, House refuses to give up, stating that they still have the mass obtained from the biopsy and can perform the tests on that.

The team suggests seven likely diseases, but only has enough tumor mass to perform three tests. First the team tests for Histiocytosis, but it is negative. Next they test for Tuberous sclerosis but that is negative also. Desperate and with only one remaining test, House wanders the hospital trying to think of his next move, when he hears from Wilson that he won the poker tournament. Wilson won only because he had kept his hole cards, two aces, hidden the entire game, prompting House to guess that the disease also kept itself secret until the end by not reaching the Gastrointestinal tract first.

House then orders his team to perform the final test on the first disease suggested: Erdheim-Chester disease. In dismay, the team pleads, telling him they can't waste their sample on a test for a disease they know he's negative for. House explains that on both Ester and Ian, he biopsied the colon, and in both cases, the disease hadn't reached the GT. The test turns out positive, Ian is saved, House finally discovers what killed Ester. The episode ends with House and Wilson playing poker and joking as they did in the beginning of the episode.

External links

* [http://www.fox.com/house/ FOX.com-"House" official site]
* [http://televisionwithoutpity.com/show.cgi?show=151/ Television Without Pity-"House" recaps]
* [http://epguides.com/House/ House Episode Guide at epguides.com]
* [http://www.tvguide.com/tvshows/house/100213/ TVGuide's Page: Full list of House Episodes]
* [http://www.housemd-guide.com/ House M.D. Guide]
*imdb title|id=0774235|title = "House M.D." - "All In"
* [http://politedissent.com/archives/1193 Medical Reviews of House: All In]