Hepatitis Autoimmune Community
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Avatar universal

Long term fever with unknown cause.

I was diagnosed with Autoimmune Hepatitis and PSC 4 years ago. Im on 1000mg of Ursofalk and 50mg of Imuran. Until November 2015. I was on 100mg of imuran but my trombocytes, leukocytes and eritrocytes counts got very low so doctors lowered the dose of Imuran. Blood cells are still low, trombocytes around 85-105, leukocytes 1.9-2.4 and eritrocytes 3.0-3.4, ALT 50, AST 52, ALP 208, GGT 85. I have a constant fever of 36.8-37.5 for last 2 months. It went down on 36.2 for 4 days in those 2 months. INR is always below 1, they rulled out momonucleosis and cytomegalo virus, all hepatitis viruses, HIV and bacteriae. Im feeling dizzy and without energy all the time, cant get enough sleep, my apetite is pretty low, I had nose bleed 3 times in last month and a half.. Im going to hospital on 11th of March but I cant just sit and wait until then.
I may have HPV, but they told me it wouldnt have anything to do with low blood cell count, fever and liver enzimes.
Could anyone suggest what tests I could do, what would You suspect and should I wait until 11.3. or go to ER?
Thanks! ^^
3 Responses
Avatar universal
I meant CRP not INR.. but INR is also fine..
Avatar universal
I have PSC as well, advanced and I am dealing with ESLD. Your fever could very well be a mild case of cholangitis, an infection in a portion of your bile ducts. I have had this several times but was lucky in not having to be admitted to a hospital for treatment - advanced antibiotics. Hope they get it diagnosed for you soon.

Your blood cell counts could be due to autoimmune attacks on the cells or die to advance periportal scarring that leads to portal hypertension (PHT). The bile ducts get fibrotic due to the PSC and this scar can start compressing the adjacent portal veins. This restriction in portal blood flow then backs up and causes your spleen to enlarge, pooling blood and causing early blood cell sequestration and elimination.

We have very complicated diseases. I hope you have a great hepatologist, it is needed for patients like ourselves. Take care and let us know how you are doing.
Avatar universal
Thank you a lot for your answer, i guess it is PHT cause my spleen is bigger than it should be..
I still have fever and feel exhausted but i wont go to ER unless it gets worse..
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