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MGUS, anemia, high WBC, should I be tested?
Mar 29, 2001

I am a 30 year old female w/severe fatigue lasting over 3 years. At times I have extreme nausea in the morning esp. in the shower, sometimes it goes away, sometimes I have it through out the day. This has been going on for about as long as the fatigue. I attributed it to my chronic sinus problems/infections/post nasal drip. I fainted for the first time last summer, went to the hospital where they determined I was dehydrated. However, they found an elevated WBC I believe it was 13-16 and blood in my urine. They decided the WBC was most likely just another one of my sinus infections. I developed dermographia in November, blood test were ran, it was determined I was fairly iron deficient w/a crit of about 32, and hemoglobin of 10 something, and a WBC of 13. More blood tests showed b-12 deficiency, monoclonal antibodies, and again blood in my urine. Tentative dx of MGUS has been made, pending bone marrow test. 3 more urinalysis showed blood in my urine. Doctor suspected kidney problems which could explain my recent high blood pressure readings. No sign of infection found in urinalysis. Finally did a CT scan, no results yet. At the age of 18-23, I was involved w/someone I later found out was involved in the drug scene (not IV) and sex w/prostitutes. Can all these problems I'm having be attributed to HIV? None of the doctors have even mentioned HIV. Thank you for your help in advance. :)

-Very worried, and tired of being tired.

Response from Dr. Frascino

Hello "Very Worried and Tired of Being Tired,"

Your fatigue could certainly be related to your anemia (hemoglobin = 10). The underlying cause(s) of your anemia are still being investigated and include:

1. Hematuria, i.e. losing blood in the urine 2. Iron deficiency 3. B-12 Deficiency

The monoclonal antibodies and dermatographia may indicate an underlying autoimmune problem. Several additional tests, including a bone marrow assessment, are apparently underway.

Do I think all this is related to HIV? I'd guess probably not. Should you have an HIV test? You had a potential exposure over 7 years ago. The only way to be certain is to have an HIV antibody test. Why not set your mind at ease and get the test? If negative, you'll be able to stop worrying. If positive, you'll be able to consider therapy that might significantly help you.

For your fatigue, discuss your anemia with your doctor. Continue to search for an underlying cause and treat the deficiencies already noted.

Hope this helps. Good luck.

RJF


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