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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Been Sick. Diagnosed Pneumonia. WBC And RBC Low. Ideas?

I have been sick for a month. I was admitted to the hospital 2x, and determined to have pneumonia but had no symptoms of pneumonia, other than fluid on the left lung . However, my SED rate is 78 and prior to this illness was normal. Also, WBC and RBC low, spleen enlarged and liver enzymes are high. I have swelling in my lower back and down the right side of my leg, doctors aren t listening to my complaints of exhaustion, and swelling in lower back. MRI with contrast of lower back indicates no infection of the 2 year old surgery site that includes hardware. Doctors are giving up, which concerns me greatly because I m not feeling well. I am a college professor and school starts in a week. Do you have any ideas of what can be going on?
Wed, 4 Sep 2013
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Rheumatologist,  's  Response
Hi. I realise from your history that there must be some sort of process affecting multiple systems. Infection can be the first to be considered in view of the fact that you had fluid in the lung, low counts, splenic enlargement and elevated enzymes all suggesting a septic process. Bacterial infections including tuberculosis can cause similar picture. The other possibility is that there is some sort of immunodeficiency due to which you have been having this syndrome. Apart from infection, malignancy is another possibility to think of, with lymphomas high up in the list of differential diagnosis. A bone marrow evaluation, and a search for lymph nodes should help. This would be my approach to your illness. Hope i have answered your query, Thank you.
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Been Sick. Diagnosed Pneumonia. WBC And RBC Low. Ideas?

Hi. I realise from your history that there must be some sort of process affecting multiple systems. Infection can be the first to be considered in view of the fact that you had fluid in the lung, low counts, splenic enlargement and elevated enzymes all suggesting a septic process. Bacterial infections including tuberculosis can cause similar picture. The other possibility is that there is some sort of immunodeficiency due to which you have been having this syndrome. Apart from infection, malignancy is another possibility to think of, with lymphomas high up in the list of differential diagnosis. A bone marrow evaluation, and a search for lymph nodes should help. This would be my approach to your illness. Hope i have answered your query, Thank you.