Q. What can be the reason for chronic recurrent diarrhea and fever for the past four years?

Hello doctor,

Four years back, I had diarrhea and a weight loss of 5 kg. Then got recurrent fevers which got better with NSAIDs and antibiotic treatment. My hemoglobin was 13.2 gm/dL, ESR 57 mm/hr, and thyroid and urine tests were normal. After a few months, I got a fever with diarrhea. Next two months I was normal, then had a fever again every 15 days. I consulted a rheumatologist and got a blood test done. My hemoglobin was 10.9 gm/dL, ESR 68 mm/hr, HCT 33.9 %, RBC 4.22 x 10*6/L, platelets 443 x 10*3/L, and WBC 8.49 x 10*3/L. I also got tested for all infectious diseases except malaria, and all were negative. No ANA or rheumatoid factor was found. CT of the chest, abdomen, and pelvis with contrast had a minor reaction to the dye, and no abnormalities were found. The echocardiogram, liver function test, urine, and stool were all normal. Now, the internal medicine doctor advised a blood test. The same report suggests ESR 53 mm/hr, CRP 16 mg/L, Hb 10.6 gm/dL, RBC 4.08 x 10*6/L, and WBC 8.37 x 10*3/L. No infectious diseases like typhoid, HIV, or syphilis were found. Electrophoresis urine protein: albumin 20.19 gm/dL, alpha-1 7.35, alpha-2 12.59, beta 11.52, gamma 48.35 %. Electrophoresis blood protein: albumin 47.5, alpha-1 3.8 mg/dL, alpha-2 10.6 mg/dL, beta-1 5.5 mg/dL, beta-2 4.7 mg/dL, and gamma 27.9 gm/L and A/G ratio of 0.90. The doctor wants to do a biopsy. I am worried.

Kindly analyze the report and advise.

Thank you.