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Suggest Treatment For Fatigue, Unintentional Weight Loss, Activity Intolerance And Appetite Loss
Question: Hi, Doctor. I have been going through a lot of testing to try to determine the cause of extreme fatique and activity intolerance. I feel like I have suddenly become very out of shape - for instance, just dressing makes me tired and winded, while the process of showering and drying my hair, etc makes me completely exhausted for the rest of the day. Just last Autumn, I was bike riding, hiking, and feeling in goood health. My symptoms of exhaustion have been happening for about 3-4 months now.
I have also had a 27 lb unintentional weight loss in the last 6 months. At first, I had decreased appetite. Now, I have been trying everything to gain weight (consuming a lot of calories) and I am still losing weight.
My doctor has run much blood work and the most recent tests have been more specific to autoimmune disease. During all of the testing, nothing has been very abnormal (just a little high or low for a few things), with the exception of a ferritin of 4, although I have only a slightly low hemoglobin - and I've always had a slightly low hemoglobin.
I just got the Anti-nuclear Antibody results back and they were abnormal. I see my doctor for a follow up in 2 weeks, but I wanted your thoughts as far as what it might mean. I also had a CT of the Chest/Abdomen/Pelvis yesterday to look for any cancer and I just read that an abnormal ANA can sometimes be the result of cancer. The results of the test were "AN IG Antibody Screen - Positive, Anti-nuclear Antibody Titer - 1:80, Pattern - Atypical/Speckled."
Thank you so much for your input.
I have also had a 27 lb unintentional weight loss in the last 6 months. At first, I had decreased appetite. Now, I have been trying everything to gain weight (consuming a lot of calories) and I am still losing weight.
My doctor has run much blood work and the most recent tests have been more specific to autoimmune disease. During all of the testing, nothing has been very abnormal (just a little high or low for a few things), with the exception of a ferritin of 4, although I have only a slightly low hemoglobin - and I've always had a slightly low hemoglobin.
I just got the Anti-nuclear Antibody results back and they were abnormal. I see my doctor for a follow up in 2 weeks, but I wanted your thoughts as far as what it might mean. I also had a CT of the Chest/Abdomen/Pelvis yesterday to look for any cancer and I just read that an abnormal ANA can sometimes be the result of cancer. The results of the test were "AN IG Antibody Screen - Positive, Anti-nuclear Antibody Titer - 1:80, Pattern - Atypical/Speckled."
Thank you so much for your input.
Brief Answer:
Bone marrow biopsy and aspiration
Detailed Answer:
Hi,
After hearing your history since you are having extreme fatigue, losing weight and since your AN IG antibody screen is positive, you could be having multiple myeloma.
It is a type of blood cancer that develops in the plasma cells found in the soft spongy tissue at the center of your bones called bone marrow.
I'd advise you to do bone marrow biopsy and aspiration test.
In bone marrow aspiration the back of the pelvic bone is numbed with local anesthetic.
Then a needle is inserted into the bone, and a syringe is used to remove a small amount of liquid bone marrow.
This causes a brief sharp pain.
For the biopsy, a needle is used to remove a tiny splinter of bone and marrow.
You may feel some pressure during the biopsy.
There is some soreness in the biopsy area when the numbing medicine wears off.
You can go home immediately after the procedure.
The bone marrow tissue is examined in the lab to see the appearance, size, and shape of the cells, how the cells are arranged and to determine if there are myeloma cells in the bone marrow
The aspirate which is the liquid part of the bone marrow may also be sent for other tests including immunohistochemistry and flow cytometry and chromosome analyses including karyotype and fluorescent in situ hybridization also known as FISH
You can consult your local doctor regarding it.
Regards
Dr Monish De
Oncologist
Bone marrow biopsy and aspiration
Detailed Answer:
Hi,
After hearing your history since you are having extreme fatigue, losing weight and since your AN IG antibody screen is positive, you could be having multiple myeloma.
It is a type of blood cancer that develops in the plasma cells found in the soft spongy tissue at the center of your bones called bone marrow.
I'd advise you to do bone marrow biopsy and aspiration test.
In bone marrow aspiration the back of the pelvic bone is numbed with local anesthetic.
Then a needle is inserted into the bone, and a syringe is used to remove a small amount of liquid bone marrow.
This causes a brief sharp pain.
For the biopsy, a needle is used to remove a tiny splinter of bone and marrow.
You may feel some pressure during the biopsy.
There is some soreness in the biopsy area when the numbing medicine wears off.
You can go home immediately after the procedure.
The bone marrow tissue is examined in the lab to see the appearance, size, and shape of the cells, how the cells are arranged and to determine if there are myeloma cells in the bone marrow
The aspirate which is the liquid part of the bone marrow may also be sent for other tests including immunohistochemistry and flow cytometry and chromosome analyses including karyotype and fluorescent in situ hybridization also known as FISH
You can consult your local doctor regarding it.
Regards
Dr Monish De
Oncologist
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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