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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35035
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My husband has been sick for 4 months now, he has a sore

Resolved Question:

My husband has been sick for 4 months now, he has a sore throat which has stopped him from eating, he has lost over 20kgs in 4 months, has had numerous blood tests, but still no diagnosis. He has low platelete count, low haemoglobin, low PCV, low ESR, low RBC, low GGT, low AST, his CAT scan has shown splenomegaly, mild axillary and inguinal adenopathy, his latest bloods show low T4 helper cells, high T8 suppressor cells and low total B Lymphocyte count. So far, all we seem to be getting is more requests for more blood tests, yet no one can actually tell us what is happening or what they are suspecting. He was sent for a test for HIV today, which if comes back negative (as we're expecting it will) means we wait another two weeks for yet another test.
Should we be asking to speak to a specialist, and if so, what sort of specialists should we be seeking?
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 years ago.


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;

1) lymphoma,

2) splenic or portal vein thrombosis

3) autoimmune hemolytic anemia,

4) hereditary spherocytosis,

5) thalassemia major,

6) hemoglobinopathies,

7) elliptocytosis,

8) megaloblastic anemia,

9) extramedullary hematopoiesis

10) Epstein-Barr virus,

11) cytomegalovirus

13) Rocky Mountain spotted fever

14) malaria,

15) leishmaniasis

16) histoplasmosis,

17) toxoplasmosis

18) tuberculosis

19) endocarditis,

20) brucellosis,

21) syphilis

22) Gaucher's disease

23) hyperthyroidism

24) sarcoidosis,

25) amyloidosis

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.

Dr. Arun

Dr. Arun Phophalia and 3 other Health Specialists are ready to help you
Customer: replied 8 years ago.

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.

Thanks again

Expert:  Dr. Arun Phophalia replied 8 years ago.


A PPD test is for tuberculosis. An hematologist is certain to give an insight.

It is pleasure and privilege assisting you.

Dr. Arun