Night sweats, fever, fatigue, occasional bruising, taking iron supplements, done CBC, falling iron levels

Posted on Tue, 5 Jun 2012 in Blood Cancer(Leukemia)
Question: My daughter is 19 and has had symptoms that come and go over the last several weeks. They are night sweats, low grade fever in the evenings, bad fatigue unexplained occasional bruising, Her periods have become irregular. She has been referred to a hematologist as she has had a low wbc of 3.3, lowest hemoglobin was 9 but is now 11.3 with iron supplements but thats as high as we can get it , sed rate of 34. The RBC is 4.05, Hematocrit 34.5, MCV 85.2, MCH 27.9, MCHC 32.8RDW 13.8 NEUT 49, LYMPH 38, MONO 10, Eosino2, Baso 1, Platelet 146
Ferritin 29 , Calculated Iron Sat 13%. These are the lowest the #s have been and have been steadilly falling since last Oct. But has been really feeling bad the last several weeks. Just curious has to what to expect when we go to the hemaotologist and what your first impression is as to what might be going on. She also has some nausea that comes and goes and very low appetite with some weight loss. Thanks so much for your time.
Answered by Dr. Rakhi Tayal 27 minutes later
Thanks for writing to us.

From the reports it is evident that she is anemic and there are chances of some bone marrow suppression due to which the adequate recovery is not happening in spite of all the efforts.

A bone marrow aspiration biopsy will clear the cause of such suppression. Sometimes this mild bone marrow suppression can be secondary to a viral infection in the recent past- decreases the synthesis of blood cells from the bone marrow.

Presence of any autoimmune disorders also needs to be ruled out.

The treatment is based on the diagnosis and severity of the problem.

Treatment is usually done by fluid infusion, steroids, immunoglobulins, blood transfusions, etc according to the severity of the condition.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Above answer was peer-reviewed by : Dr. Radhika
Follow up: Dr. Rakhi Tayal 12 hours later
Thank-you for your quick response. It was the rheumatologist who referred her to the hematologist. She did all of the work up for auto immune due to the fatigue and body aches and the only test that came back positive was the slightly elevated sed rate but it was the other blood work listed in my email that concerned her and prompted the referral to the hematologist. Also, I forgot to ask if there is a genetic predisposition to blood cancers or marrow issues as both of my daughters great grand fathers died from the late onset leukemia and their son has it now. Also, her low grade fever has returned every night this week with worsening fatigue and a slight sore throat. Thanks again for your help. Her apt is not until Sept 26th and its so hard not to wonder if it is a marrow issue.
Answered by Dr. Rakhi Tayal 30 minutes later

Thanks for writing again.

Genetic predisposition is commonly seen in case of blood cancers. In your daughter's case, bone marrow suppression is more likely, which is less likely to have genetic predisposition.

High grade fever is due to infections that are flourishing due to low WBC counts.

Further investigations will help in diagnosis.

I hope, I have answered your query,

Wishing your daughter an early recovery.


Above answer was peer-reviewed by : Dr. Jyoti Patil
Answered by
Dr. Rakhi Tayal


Practicing since :2001

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