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I have been tested for a ton of things to find out why I am…

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I have been tested for...
I have been tested for a ton of things to find out why I am running chronic low grade fevers for the last 5-6 months as well as having elevated white counts and sometimes elevated platelets and SED rates. Since January I have had a ton of CBS. All except two have been elevated for white counts. Only two have been in normal range. Have probably had 10-15 CBCs done in this time. I just had a bone marrow biopsy that came back mostly normal. The only thing that showed up was some anemia. I had an upper gi series yesterday with small bowel follow through to rule out Chrone's which only showed a minor hiatal hernia.
So far the infectious disease doctor I am seeing says we have ruled out: CMV, EBV, Endocarditis, Liver abscess, Urinary infection, HIV, Valley Fever, Lyme, Sinus infection, Abdomanal abscess, hepatitis...
I went to see my GYN for my annual pap and told him what had been going on. He ran some cultures and did an ultrasound. On the ultrasound there was fluid in my uterus. He thought it might be either my body getting ready for my period or possibly polyps. I am to follow up with him next week 4 or 5 days in to my cycle for a repeat ultrasound.
I am scheduled for a Gallium scan next week as well as an Echocardiogram.
My internist says that we've ruled out the top 99% more common infections and that we are looking for something rare.
My physical symptoms are: complete exhaustion, chronic fevers, tired/burning eyes and occasional stomach pain (although I've been diagnosed with Irritable Bowel so stomach issues are really nothing new).
One more thing...this all started back in December '09. It started with a bad sinus infection. A week after I was done with the meds for that, I developed a very serious peri-orbital cellulitis infection that landed me in the hospital for 3 days on IV antibiotics-vancomycin and flagyl. Looking back, I think that after leaving the hospital I was doing better for a week or so energy/health wise and then the fatigue and fevers started. I ended up with another sinus infection a few weeks later and although my sinuses are fine I've never really felt like myself since. I've had a total of 3 sinus CAT scans done and we have ruled out the sinuses as the cause.
Any ideas or suggestions? As you can imagine I am very anxious to get to the bottom of this. Thank you.
Submitted: 8 years ago.Category: Medical
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Answered in 4 hours by:
6/26/2010
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago
Louise Sivak, M.D.
Category: Medical
Satisfied Customers: 3,499
Experience: Pediatrician, Board-certified in Hematology/Oncology
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I am sorry you have all these issues.

Please tell me the numbers from your two most recent CBCs and when were they done.

Thanks,

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Customer reply replied 8 years ago
Do you want all the numbers or some particular numbers? I am waiting for my most recent one that was done this Tuesday, but have others. Let me know which numbers you are interested in. Thanks for your help.
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago

Thanks.

WBC, Hgb, Hct, MCV, plt, all numbers in "differential count".

You posted that you had "some anemia" diagnosed. Did your doctor say from what? Are you being treated for this now?
Thanks,

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Customer reply replied 8 years ago
The anemia was mentioned to me after the bone marrow.
Here are a few of the labs
5/24
WBC 12.6 high
LYM 2.7
MID .6
GRAN 9.3 high
RBC 3.8 low
HGB 11.4 low
HCT 36.1
MCB 95
MCH 30
MCHC 31.6
PLT 455 high
MPV 7.7
4/30
WBC 15.4
RBC 3.58
HGB 13.1
HCT39.3
MCV97.9
MCH 32.6
MCHC 33.3
PLT 482
I've also had a few high ESR/Sed rates around 30 on a couple of the labs.
Bone marrow diagnosis synopsis says: Normocellular bone marrow with trilineage heatopoiesis and mild eosinophilia
Decreased storage iron
no granulomas or malignancy blood identified
Peripheral blood: Leukocytosis with absolute neutrophila and absolute eosinophilia
Mild thrombocytosis
Does that help?
Customer reply replied 8 years ago
Also, I just saw on the bone marrow report the following numbers from blood taken that day. will only list the ones that are abnormal
WBC 14.2
RBC 3.96
PLT 472
mcv 97.8
rdw 14.5%
neutrophils 56%, bands 2%, lymphocytes 32%, monocytes 5%
basophils 1%
It also says there is mild nospecific anisopoiklocytosis.
There is absolute neutrophilia and absolute eosinophilia
Ocasional reactive lymphocytes and monocytes are seen. The platelets are mildly increased in number and normal in morphology.
Thanks.
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago

Hello,

Thank you for the helpful information.

Your CBC test results say that you have mild anemia (Hgb 11.4). I assume the bone marrow was done to look for why. It shows no evidence of leukemia or cytopenia (too low of any of the three immature types of cells that mature into platelets, white and red blood cells, so it essentially does not give a reason for your anemia.

In my opinion, your doctor should do some tests to look for the cause of your anemia. Your MCV is slightly high, so testing your blood levels of B12 and folate is reasonable. Also making sure you have no microscopic bleeding for example in your GI tract.

Hope this helps some and please tell me if you have more questions.

Best,

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Customer reply replied 8 years ago
What kinds of causes of anemia should they be looking for?
Doctor: Louise Sivak, M.D., Doctor replied 8 years ago

Hello,

As I wrote, blood loss, or folate and/or B12 deficiency would be at the top of my list from your blood count parameters. If these are ruled out, and you do not improve over time, then rarer causes will be sought such as intestinal malabsorption.

Best,

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