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

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 23, 2023

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.

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Hello,

Welcome to icliniq.com.

You have chronic diarrhea with fever, according to mentioned history. So colonoscopy and routine stool micro examination can be done. Kindly let me know which type of biopsy your doctor wants, colonic or bone marrow biopsy. Also, attach your reports so I can check them and comment more. Your hemoglobin is low, and your ESR (erythrocyte sedimentation rate) is high. So chronic inflammation or some organic pathology might be present. You can attach all your reports, and then further discussion can be done.

Hope this helps.

Thank you.


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