Its not diabetes or hiv so what is it?

[Rich UK]

I've recently posted twice to the STD forum which helped eliminate many of my concerns regarding hiv after a low/no risk encounter back in early July.

I tested negative for all stds and hiv at 13 and a half weeks but have now been having symptoms of aching legs, persistent oral candidiasis (despite nyastatin suspension) and a tender neck gland for 5 weeks or so. I am not visiting my private doctor any more as he is convinced its hiv despite the negative test and the gum clinic's assertion that I should look for another cause.

I have high levels of ebv antibodies in my blood apparently - hence they have diagnosed glandular fever, but does glandular fever cause oral candidiasis? My sister has sjogren's syndrome and I have suffered from frequent sinus infections, penile rashes and dry eyes for some 2 to 3 years now. Should I push for a referral do you think or just wait out the glandular fever? Also, should I ask for fluconazole for the candidiasis or wait? I have also tested negative for diabetes by the way.

My anxiety levels are low, I'm working and just dealing with this thing but I'm hitting walls with who to see and what to do. Help appreciated.

[Kevin Pho, MD]

EBV and other viruses (i.e. CMV) can lead to glandular swelling.  If the glands continue to be swollen after several weeks, then further diagnostics (i.e. a possible lymph node biopsy) can be considered.  

Regarding the candidiasis, the two more common diseases - HIV and diabetes - have been ruled out.  Fluconazole can be used for treatment, as well as nystatin swish and swallow or clotrimazole troches.  

Sjogren's syndrome can be considered.  A referral to a rheumatologist can be considered.  Blood tests looking for autoantibodies, anti-Ra and anti-La, can be suggestive of the diagnosis.  

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

[ArmourGal]

you have a couple of things that put you at risk for Hashimoto's disease (autoimmune thyroid disease).  Having glandular fever is a risk factor hypo as well as having someone in the family with an autoimmune disease (the sjorgren's).  And since you've mentioned a sore neck gland, i'm wondering if it's your thyroid gland. You also mentioned some things that were symptoms of hypothyroidism, like frequent sinus infections and skin disorder.

To check for this, ask for thyroid antibody testing - not just the standard TSH test for thyroid dysfunction.  I'd also want to see the actual thyroid hormone labs, Free T4 and Free T3.  
Cindi

[Rich UK]

Thanks Cindi,

Those comments are of help to me. I will mention this to the doctor at our next scheduled appointment. They have just done some blood tests today to check liver function since my bilirubin levels were raised last time.

[Rich UK]

Thanks for your help - this has been useful information for me to decide what to do next.

[Rich UK]

Just a note to say that I've now been referred to a rheumatologist and the blood test has been done do look for the autoantibodies. The tongue condition has got much better but the gland remains swollen. They have said that CMV needs to be ruled out so they have done some tests for that. Thanks again for the help.