Atyp Lymph

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.

[Kevin Pho, MD]

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

[vreyna209]

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