#2041 ·
Joseph Taylor3 said:Update—on the latest blood panel, lymphocyte levels are still climbing, sitting at 3.95. My doctor thinks nothing of it. Over the last four rounds of testing, these numbers have been on a steady upward trajectory; the last two were actually above the reference range. Add in some swollen lymph nodes, and she’s still telling me everything is fine. No referrals, no follow-up tests, nothing.
To whom it may concern,
It’s getting difficult to keep up via this forum. Honestly, you need a proper, comprehensive review to figure out your next move. When you step back and look at everything you've posted here, a pattern starts to emerge: changes in your salivary glands—specifically that inhomogeneous echostructure—which might even be enlarged, along with dry mouth and a coated tongue. Then there's the seborrheic dermatitis, the fatigue that feels like a lingering virus, digestive issues, and those swollen lymph nodes in your neck. It all points toward something specific.
The differential diagnosis for these symptoms is quite broad. It could be anything at all, or it could be nothing significant. A few possibilities come to mind, but without a proper exam, I’d rather not speculate—I have no desire to add to your confusion.
Two things are likely linked here: seborrheic dermatitis and dry eyes. It’s probable that the dryness stems from an impaired tear film, triggered by the involvement of the oil glands in the eyelids.
Infectious mononucleosis—specifically the strain triggered by the Epstein-Barr Virus—doesn't typically linger this long unless you're dealing with some sort of complication.
I find it unlikely that Candida, or a systemic Candida infection, is the actual culprit behind these symptoms.
We generally try to bundle various symptoms under a single diagnosis whenever possible. But sometimes, you're looking at multiple distinct conditions hitting all at once. Without a full workup, it’s tough to tell where one ends and the other begins.
Since an internist usually provides the most comprehensive evaluation—provided they actually take the time to dig in—a thorough consultation might be the best way to figure out the next steps. It would be wise to go in with updated labs: a complete blood count, CRP, AST, ALT, GGT, bilirubin, alkaline phosphatase, LDH, CK, glucose, uric acid, and potassium. You might also want to include a serum protein electrophoresis and a peripheral blood smear to give them the full picture.
Sandra Vaughn50 said:It was enough to determine the PV on your end.
Looking at these results, it seems like they came from a primary care clinic—maybe a local community health center. In those settings, it’s pretty common practice to "automatically" bundle an INR test with a PT. If I recall correctly from my time working in primary care, the lab requisition forms themselves often have a single "PT/INR" checkbox. It’s basically a standard package where both parameters are determined at once. 😉
