Get Sticky Mucus In Mouth, Stool And Urine. What Kind Of Disease Is This?
Welcome to Healthcare Magic and thank you for writing to us.
With your background of IgG deficiency and on IVIG therapy, COPD (probably on steroids), fibromyalgia and arthritis you are at high risk of getting infections. My first guess (without pictures) would be oral candidiasis and one can also get a similar fungal rhinosinusitis. That would explain your current symptoms.
The diagnosis is usually clear when it is seen (which your doctor should be able to diagnose without tests), and you must let your regular doctor (Immunologist) know of this at your next infusion. There are several immunodeficiency disorders (especially the antibody deficiency disorders) where a genetic diagnosis is still not possible as in your case.
Treatment for oral candidiasis involves oral nystatin mouthwashes, or Candid-B oral paint. You will also need fluconazole tablets for a few months, or itraconazole if your doctor prefers that.
I hope this was useful.
Best Wishes.
Thank you for writing with an update.
Thrush is candidiasis (in layman terms) and IVIG has little effect on it, so you are completely right in saying the IgG infusions are not helping.
I hope you have had an upper GI (endoscopy) investigation to ensure that there is no candidiasis in your food gullet, as oral nystatin will NOT be effective for this. You will need oral antifungals for this. It is possible that unless an extended fungal culture studies are done, one will not know the type of candida you have. The common one is candida albicans, but there are several others, and the treatment options may be different.
As for fungal rhinosinusitis, you will need a CT Paranasal sinuses, and all of this should be covered by your insurance company if they have agreed to fund the IVIG therapy. Please get in touch with your hospital or the insurance company to see why this is not the case.
The bone marrow report is almost normal, why I say almost is because of the mild macrocytosis, which may mean either B12 or folate deficiency, and you should be on treatment with B12 injections and oral folvite 5mg daily.
If there is evidence of bronchiectasis on CT Chest, the constant mucous or phlegm will be explained by this and the Chest physician should look into this. Sometimes, increasing the IVIG dose works, and as there is a little amount of antibodies against most bacteria, viruses it tends to work in high doses.
Let me know if I can be of any more help.
Best Wishes.