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Suggest Treatment For Lack Of Appetite, Excessive Sweating And Itchy Scalp In An Elderly Person
Question: hi-I'm a 53 yr old woman with SLE and Sjogrens. For the past few months I have been more tired than usual, have had a poor appetite, have excessive sweating (day and night), low grade fevers at night, and bad scalp itchiness. I have some rubbery enlarged lymph nodes on the right side of my neck, in a large area. Recent bloodwork shows IgA of 500 (others normal), and increased monocytes and basophils, which are both new findings. My rheumatologist has mentioned the assoc. of Sjogrens and lymphoma, and seemed somewhat concerned that this could be what's going on. Any insight? Thanks!
Brief Answer:
Sle /sjogre syndrome
Detailed Answer:
good evening
thank you for writing on health care magic
well considering your change of symptoms , it is essential we rule out a couple of things. either it can be a flare of the disease or something new which has emerged, lymphoma being a possibility.
i would like to know the details of your treatment? i believe the blood work has been ok so far for you. but have they checked for esr and complement levels as well? As both can inidicate the disease activity...
since you have had recently enlarged lymph nodes, the best possible way out is we get a biopsy done for the same. It will give us the exact idea what is going on. If the result is reactive, it is probably due to disease getting active and we need to increase your treatment. Lymphoma management is different.
Hope the information was useful
do let me know for more queries
regards
dr naval
Sle /sjogre syndrome
Detailed Answer:
good evening
thank you for writing on health care magic
well considering your change of symptoms , it is essential we rule out a couple of things. either it can be a flare of the disease or something new which has emerged, lymphoma being a possibility.
i would like to know the details of your treatment? i believe the blood work has been ok so far for you. but have they checked for esr and complement levels as well? As both can inidicate the disease activity...
since you have had recently enlarged lymph nodes, the best possible way out is we get a biopsy done for the same. It will give us the exact idea what is going on. If the result is reactive, it is probably due to disease getting active and we need to increase your treatment. Lymphoma management is different.
Hope the information was useful
do let me know for more queries
regards
dr naval
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for your answer. My lupus treatment is plaquenil 200mg BID and prednisone tapering off-now at 2 mg a day. I cant take NSAIDs due to hx of GI bleed due to longterm use of them. My complement tests were normal but C4 was 19 last wk which is lower than ususl.most recent esr was high 40's. Does lymph node need to be bigger to biopsy? These are small and highly movable.should serum calcium be checked? Was high in recent past which was unusual. Thankd
Brief Answer:
Further evaluation
Detailed Answer:
Good evening
Sorry for the delayed reply. had a long duty
1. Lymph node biopsy: It need not be very big for biopsy but cant be too small either. AN ultrasound will help detect the size of the node and the best one possible for biopsy. It is important to localize as a lot depends on the report of the biopsy
2. How high was the calcium. YEah it is unusual especially when you are on steroids also as they help remove the calcium. DId thecy check your PTH levels as well??
All in all, a Biopsy would be the conclusive here. OR else we can increase the treatment for your Lupus
Do let me know for more queries. Would be happy to help out
Hope the information was useful
REgards
Dr Naval
Further evaluation
Detailed Answer:
Good evening
Sorry for the delayed reply. had a long duty
1. Lymph node biopsy: It need not be very big for biopsy but cant be too small either. AN ultrasound will help detect the size of the node and the best one possible for biopsy. It is important to localize as a lot depends on the report of the biopsy
2. How high was the calcium. YEah it is unusual especially when you are on steroids also as they help remove the calcium. DId thecy check your PTH levels as well??
All in all, a Biopsy would be the conclusive here. OR else we can increase the treatment for your Lupus
Do let me know for more queries. Would be happy to help out
Hope the information was useful
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks! One more question-yesterday morning i noticed a golf ball size hard lump on my sternal clavicle. Painless and very hard. Didnt show on xray at urgent care-said must b soft tissue. Now really concerned. Blood calcium has been running high but not on recent labs
Brief Answer:
Neck Lump
Detailed Answer:
Good evening
Well, the neck lump is a bit unusual which has cropped up. The hard swelling, doesnt seem good. But X ray is not a specific investigation for it. We need to get an ultrasound done for the lump and see the depth and the content of it. I understand your concern and would be best we sort it out quickly.
When is your next appointment with rheumatologist?We need to get the FNAC/Biopsy Asap so we know where we are heading.
Do let me know what your rheumatologist says
Regards
Dr naval
Neck Lump
Detailed Answer:
Good evening
Well, the neck lump is a bit unusual which has cropped up. The hard swelling, doesnt seem good. But X ray is not a specific investigation for it. We need to get an ultrasound done for the lump and see the depth and the content of it. I understand your concern and would be best we sort it out quickly.
When is your next appointment with rheumatologist?We need to get the FNAC/Biopsy Asap so we know where we are heading.
Do let me know what your rheumatologist says
Regards
Dr naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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