Wow. I'm a premed student and my dad has had mystery symptoms for years and is on over 20 medications for all kinds of "diseases" and symptoms. After reading up on what hairy cell leukemia is, I may have found the answer. Does anyone have some info on this that may be helpful for me? Thanks for posting @DrNick3000
Out of interest would you classify these abnormal RBCs on the smear as burr or spur cells?
1. Thre are multiple acanthocytes in the smear.
2. Chemotherapy for HCL: cladribine or Pentostatin
Was the patient in DIC?
@krk213 what makes you believe that your father has HCL?
@DrNick3000 Long story short, he has been diagnosed with #Ankylosing-spondylitis, #Behçet-syndrome and #Pernicious-anemia. He has weakness, easy bruising, back/joint pain, neuropathy and itchy bumps with a rash that appear on his hands/feet symmetrically left and right when prednisone is lower than 15mg.
Not sure if good news or not, but ankylosing spondylitis always starts at the sacroiliac joint by definition so if he doesn't have SI joint involvement then his back problems are of another cause. Good luck to him!
Pernicious anemia (b12 type) can be an underlying cause for many of the symptoms you have listed here and in the other posts. I suspect several of the diagnosis clumps are just partial explanation for subgroup symptom sets.
@DrNick3000 He is on over 20 different medications for the symptoms. All of this began about 4-5 years ago and none of his drs have been able to really explain what's going on. He has been on prednisone for a few years now as bad as it is for him, because he breaks out with a bad itchy rash when they taper him down
@DrNick3000 Oh and I forgot to mention the #Gastroparesis and #Splenomegaly
Sorry to hear that. Does not sound like HCL, but it's possible. What's his CBC like? ANA? RF? RPR? Does he really have sacroilistis on X-rays ? What's his EF and echo? How big is his spleen on echo ? Does he have liver disease on echo?
@DrNick3000 He's ANA+ and HLA-B27+. I'm not sure about the others. X-rays do show some fusion in spine but not sacroiliac yet, which may be due to his relatively young age of 49. What's EF? His spleen has been enlarged for some time now. Not sure of the size though. I can get that soon though.
@DrNick3000 I have not heard anything about liver disease. His liver enzymes are good though. Oh another thing I forgot to mention was his B12 deficiency. He gets monthly injections to keep it in normal range.
EF left ventricular Ejection Fraction.
@DrNick3000 Some of this may not be pertinent, but here are some of his test result abnormalities. Hypertension, high cholesterol, Absolute lymphocytes and absolute Eosinophils were low, creatine slightly elevated and testesterone low.
Also he has #Sjögren's-syndrome, #Osteopenia, #COPD, #Vasculitis, and #Degenerative-disc-disease. He has been diagnosed with every single one of those oddly enough. There has got to be more to this story. I'm thinking there's an undiscovered underlying illness that they haven't pinpointed yet that is causing this
@DrNick3000 Sorry for the long answers, but I will take all of the help I can get. I appreciate any info or suggestions you have. Btw, I don't believe he has any liver disease or has had EF tested. Thanks for your time.
@DrNick3000 While going through old paperwork I forgot to mention #Uveitis #peripheral-ulcerative-keratitis and #Dyshidrotic-dermatitis. Also, the last time the spleen was checked was in 2010 and it was slightly enlarged at 13.4cm.
Does not sound like HCL. Some connective tissue disorder or Crohn's disease ?
My husband was just dx with HCL
@krk213 just wondering what's his occupation and what's his oral history? Does he have silver fillings, root canals, bridges, caps, screws and which teeth if yes to any. When did it truly start or pushed it over the edge to this point?
I don't recall his dental history. The splenomegaly and pancytopenia was noted 9 months before treatment was started.
Retired Navy veteran, no exposure to traditional carcinogens.I do not remember, but who does not have silver fillings a root canal?
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