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Family Medicine (Expert Forum)
Atyp Lymph
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Atyp Lymph
by jerbark, Oct 10, 2005 12:00AM
Background: I'm a 47yo female, overweight but fairly healthy. I've had a double mastectomy for DCIS (stage 0 breast cancer), first diagnosed in 1998 and last in 2003. Blood pressure a bit high 150/90, cholesterol high normal, glucose high normal.
My usual body temp when I'm feeling good, is approx 97.6-97.8. I've recently ended a period of about 3-4 weeks with a constant low grade fever of 99.6 - 100, which for me is high. I've also had body aches in my shoulders, elbows, hips and knees (but not wrists, fingers or feet) and have been very tired.
Doc took tests that came back with the following results:
Low (3.4) Potassium
CBC normal except for:
High (15.7) RDW
High (74) Neutrophil
Low (16) Lymphocyte
High (2) Atypical Lymph
ANA tests:
Positive for ANA screen
ANA Pattern "speckled"
ANA Titer (1:160) normal
RA, Quant (<7) normal
Estradiol, FSH and LH were all within normal range
Urine test normal
TSH (.53) normal
Blood culture - no growth after 5 days
Doc seems uncertain of where to go next to make a diagnosis. My temperatrue is now back to normal (97.8) and was apparently replaced with mild diarrhea for the past week, which I've never had for so long. Any suggestions? Thanks.
My usual body temp when I'm feeling good, is approx 97.6-97.8. I've recently ended a period of about 3-4 weeks with a constant low grade fever of 99.6 - 100, which for me is high. I've also had body aches in my shoulders, elbows, hips and knees (but not wrists, fingers or feet) and have been very tired.
Doc took tests that came back with the following results:
Low (3.4) Potassium
CBC normal except for:
High (15.7) RDW
High (74) Neutrophil
Low (16) Lymphocyte
High (2) Atypical Lymph
ANA tests:
Positive for ANA screen
ANA Pattern "speckled"
ANA Titer (1:160) normal
RA, Quant (<7) normal
Estradiol, FSH and LH were all within normal range
Urine test normal
TSH (.53) normal
Blood culture - no growth after 5 days
Doc seems uncertain of where to go next to make a diagnosis. My temperatrue is now back to normal (97.8) and was apparently replaced with mild diarrhea for the past week, which I've never had for so long. Any suggestions? Thanks.
Doctor's Answer
by Kevin Pho, MD, Oct 11, 2005 12:00AM
, Oct 11, 2005 12:00AM
Various viruses can lead to atpical lymphocytes. This can include mononucleosis, toxoplasmosis, CMV, rubella, hepatitis and rubeola (measles).
Each of these diseases can be tested for if clinically suspected.
The positive ANA test can be suggestive of rheumatologic disease. You can consider a referral to a rheumatologist for further tests for autoantibodies - including double-stranded DNA, histones, and chromatin. These more specific tests can be suggested of specific rheumatological disorders.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Each of these diseases can be tested for if clinically suspected.
The positive ANA test can be suggestive of rheumatologic disease. You can consider a referral to a rheumatologist for further tests for autoantibodies - including double-stranded DNA, histones, and chromatin. These more specific tests can be suggested of specific rheumatological disorders.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
