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He should be seen by a specialist. Either an hematologist or a clinical immunologist would be best to consult with. A lymph node biopsy or bone marrow biopsy should be able to clinch the diagnosis. Following diagnosis would be consider for his symptoms;
2) splenic or portal vein thrombosis
3) autoimmune hemolytic anemia,
4) hereditary spherocytosis,
5) thalassemia major,
8) megaloblastic anemia,
9) extramedullary hematopoiesis
10) Epstein-Barr virus,
13) Rocky Mountain spotted fever
22) Gaucher's disease
26) rare type of leukemia
Investigations needed (if not already done), a PPD test, blood cultures, a CT scan of the torso.
Please feel free for your follow up questions.
Thank you for your advise. I will ask for a referal for a haematologist, as I suspected we should be seeing one anyway. When I requested this today, our GP said that he should be sent to an "Infectious Diseases Specialist" which I don't really agree with, I would've thought a haematologist would be better??
He has had a torso CAT scan (that revealed the enlarged spleen and axillary and inguinal adenopathy).
Not sure what a PPD test is, but I will request it anyway.
A PPD test is for tuberculosis. An hematologist is certain to give an insight.
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