fever since 3 months , still undiagnosed , pls help me

[chandrabhan]

i am from india. i have fever  since last 3 months.(low grade). morning 99 degree and evening 100-101 degree. all blood tests came negative.
symptoms-  dry mouth whole night, sour taste in mouth since 3 months. weight reduced from 64 to 55 kgs. and hemoglobin reduced from 10.4 to 5 . blood transfused 2 units  last month so now heamoglobin is 7.7. still fever on. some doctors saying its refractory anemia with nutritional deficiency.    lab tests values are as under-
RBC COUNT-3.4 ,  PLATELET COUNT- earlier 11 lakhs now 6.5 to 8 lakhs.
ESR- earlier 123 now 80.  WBC- earlier 32 now 15.
bone marrow biopsy- neagtive. jak-2 - negative. tb gold- negative-  ana- negative

feritin serum-815,  iron serum - 12
iron binding capacity- 144   % saturation- 8   vitamin b12- 169

food intake had decreased drastically due to bitter taste in mouth and fever.

any kind person pls help, i can upload all test reports if needed.

[mkh9]

I'm not sure I would ask your doctor.
mkh9

[chandrabhan]

Hi
     I met an oncologist. He said its refractory anemia with nutritional deficiency.  He advised me to blood transfuse 2 units of blood .  How much blood could be transfused to an anemia patient in a month. Thanks

[mkh9]

So firstly your lab results do show Iron deficiency anemia by the low iron, low % saturation, low hemoglobin. I would see a hemologist perhaps and/or a intestinal doctor to make sure there is nothing else too. Some other tests you should check too are kidney and liver function tests.. Do you have any bleeding any where or black stools when you go to the toilet? Some symptoms of Iron deficiency anemia are low grade fever, <101 F, Extreme fatigue, shortness of breath, poor appetite (more often in children) and other things. Since the high platelet count  can be from anemia but usually not that high. Also the low B12 can be from poor diet or being vegan and not supplementing B12. But it can be from other things. Do you have any bowel issues? Some drugs that are given to treat iron deficiency can give you a low grade fever <101. So, I think because your platelet is so high if you haven't been to a hematologist and/or had these other tests you should make sure everything is okay. Something is causing the hemoglobin  to become low. It is not just diet. There could be something else going on. Also, do you have any bleeding hemorrhoids? Anything like that can lower the hemoglobin if it is constant. Think about all this and I would make a list of your symptoms and the tests you had done and see a doctor.
take care,
mkh9

[chandrabhan]

thanks for giving time. can i mail you my all lab reports if u wish to see them . my pet ct report says little concern in intestine and lungs. chest xrays are clean. what tests should i go for intestine.
please tell how to send my reports.

[mkh9]

I am not a doctor, I am a microbiologist. So, I don't read CT scans or Xrays.  It is great they are clear though. I am just concerned that your platelet count is so high. That is why I suggested the hematologist. You may not need the GI doc then.  I would talk to the hematologist though to make sure they don't want to do any other tests or that the platelet count is okay. It is up to the doctor to decide which tests they want to do. But, so far it may just be related to anemia. But usually there is a cause of such a low hemoglobin. So it would be good to find out the cause of that as well.  But it is hard to control an anemia like this so to get it under control that is why you need a good hematologist. Were there any remarks on the complete blood count that stated you had any abnormal cells? If so then maybe the doctor can explain this to you.
Regards,
mkh9

[chandrabhan]

Hi
     I dont have any symptons you specified nor did i swim. I have negative malaria reports. No diarhoea and stool rest ok .
   I want to ask one thing do anemia patient have fever for more than 3 months ? If yes then i will recover soon by eating healthy.
But problem is my todays cbc report
Heamoglobin - 7.5
ERS- 90
Rbc - 3.15
Wbc- 13600
Platelet-999000
     Fever still 100 at night and 99 at day tiime. Mouth more and more dry at night time. Food intake reducing .
Pls help

[mkh9]

Hi, Sorry you have this problem. I can't understand all of the blood results. are lakhs leukocytes or white blood cells? I don't know what jak is?  But over all it sounds like you have an  anemia and need to be monitored by a doctor for treatment. Not sure what your platelet count is either. I'm glad to see your TB was negative. Do you have any other symptoms like cough, night sweats, diarrhea? Were you swimming in any water, did you get bit by any mosquitoes or other insects? If you have diarrhea you could get a test done on the stool for culture and parasites. It sounds like with a fever you could have some thing like malaria or anything really that is infectious. But I don't see any symptoms other than anemia.
Regards,

mkh9