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Enlarged spleen with pain, high calcium in blood, weight loss, nausea, tested for sarcoidosis. Diagnosis?

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Our 48 year old male family friend has been suffering for months with intermittent and fluctuating symptoms that include: enlarged spleen with acute pain, high calcium in blood, extreme fatigue, weight loss (20 pounds in 2-3 months on an normal weight frame), chills, nausea, loss of appetite, vomiting and probably a few other symptoms that aren't coming to mind at the moment. He has been tested for sarcoidosis and it was negative. He is hospitalized again today and yet there hasn't been a diagnosis. What do you suggest?
Posted Thu, 12 Apr 2012 in General Health
Answered by Dr. Robert Galamaga 35 minutes later
Hello and thanks for the query.

Your question is a good one and I will work on providing some good information and recommendations regarding what is going on.

There are many symptoms occurring here and a systematic approach needs to be taken to determine what is going on. With the enlargement of the spleen this can happen in conditions where there is a process going on which causes inflammation of the spleen and destruction of blood cells within the spleen. A careful reiew of his red cells, white cells and platelets would allow for analysis of this issue.

Increased pressure in the liver can cause splenic enlargement as well and the most common cause of that would be liver damage from alcohol or possibly from a hepatitis virus.

He must have some kind of kidney failure going on as you indicate he had a kidney biopsy as well.

In your friend there seem to be multiple organ systems involved in this disease process and it may take some time for the doctors to sort things out.

The weight loss, abnormal calcium and enlarged spleen are certainly concerning but I cannot tell you exactly what is happening in the absence of reviewing more test results and imaging studies.

I thank you again for the query and hope my response has been informative If you have any additonal concerns or additional information you could provide I would be happy to address or review them.


Dr. Galamaga
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