New Symptoms: which tests...which possible causes?

Mar 28, 2004

I have additional symptoms now - shortness of breath/difficulty breathing, gastric reflux despite taking 40mg of Nexium at night before dinner (I wake up with mouthfuls of food most nights, which is terrible), pharyngitis and a tendency to bruise deeply now, each time that blood is drawn (though platelets are OK in number).

What tests would you order if I were your patient? What causes would you suspect with these symptoms? Can HIV alone cause these and, fi so, what is the best treatment?

My CD4's are >600 and VL <2,000. Have not started HAART yet, though wonder if these symptoms plus some prior chronic ones wouldn't warrant giving it a try?

Many thanks for your help.

Response from Dr. Pierone

It sounds like you have severe gastroesophageal reflux disease (GERD). This is associated with reduced competence of the lower esophageal sphincter muscle. This is probably not related to HIV and is a very common disorder. You should see a gastrointestinal specialist and consider an upper endoscopy test for a definitive diagnosis.