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Doctors Lounge - Oncology Answers
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| RachelS
- Tue Nov 10, 2009 9:48 pm |
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I am a 21 year old female who has seen every doctor in my area. I am HIV negative (I had 6 tests this year alone) but have been suffering from signs of immune suppression and no one can tell me why. I have had, and still do have, other chronic health problems. All of my labs are normal besides my RDW. (I was anemic for 8 or more years, when it spontaneously cleared up last month, despite bruising MUCH more than I did. My RDW is still high at 16.7 and is the lowest it has been ever.) I have had abdominal pain for 2 years (upper right and epigastric) and have had 2 negative endoscopies, 1 negative colonoscopy, negative Hep ABC screen (was tested because I had jaundice and brown urine). Liver and pancreatic function panels are normal, and I was negative for porphyria. For a year and a half I have been suffering from general malabsorption (passing sometimes completely undigested food of all kinds) and was put on Creon for it, but it did not help, and about a year ago I started getting diarrhea almost always, sometimes bloody (like I said, no signs of inflammation on biopsy). I experience night sweats on and off, I had them every night for 6 months straight, just drenching, and every few weeks run a low grade fever (between 99.1 and 100.5, I am normally around 97.8). I occasionally get swollen glands in my groin area, and those hurt. I also have 2 glands that the doctors always miss, they're right behind my jaw, under my ear. One of them swelled to over and inch about a year and a half ago, and I never saw anyone about it. Since then, it swells daily, is hard, doesn't hurt (although its under a tendon in my neck, and when it swells, then tendon gets hard and THAT hurts), and now it feels like a there's a smaller one stuck to it. I also developed unstable blood pressure, both too high at times, and too low. It may be irrelevant, but I don't know what is anymore. I have arthritis, but I have had that since I was 14 or 15, but I also get pain in my right leg, my thigh bone. It usually aches, but sometimes is excruciating to the point of collapsing my leg from under me. I know it doesn't seem to make sense, but could it be lymphoma? I've spent the past 2 and a half years sick and last year researching, and I need to know if this could be a strange presentation of lymphoma or if it is something else.
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| Dr.M.Aroon kamath
- Fri Dec 25, 2009 12:35 am |
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 Hi,
Chronic mucocutaneous candidiasis (CMC) refers to a group of disorders which are charecterized by persistent and recurrent infections of nails, skin, and mucous membranes by Candida albicans and occasionally other candida species.CMC are a group of heterogenous disorders where there seems to be a 'selective' inability to clear infection with the yeast Candida, resulting in persistent debilitating symptoms.
CMC could be
- familial (inherited)or
- non-familial (non-inherited).
The familial form could be
- autosomal dominant or
- autosomal recessive.
CMC can be
- associated with endocrinopathies/inflammatory disorders or
- not associated with endocrinopathies/inflammatory disorders.
CMC can be
- early onset (usual) or
- late onset.
The association of CMC with squamous cell carcinoma of the oral cavity or oesophagus has been reported in patients with 'autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy' (APECED) syndrome.
There are reports of patients with late onset chronic mucocutaneous candidiasis who developed lymphocytic lymphoma.
I am in no way implying that you have CMC. As you are immunocompetent & your symptomatology is very complex & several aspects need to be connected up, it may be worth starting the process by first excluding late-onset CMC.You may need (among other things) a fine needle aspiration cytology from the cervical lymph node.
Best wishes!
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