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What Causes Severe Weight Loss With Nausea, Night Sweats And Cold?

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Posted on Tue, 29 Dec 2015
Question: xxxxxxxxxx, 58 years old, 5'5", 127 lbs (loss of 25 pounds over 10 month period without trying) however, I have experience regular nasuea, night sweats, and I am constantly cold. I saw the endoconologist 9/2015 and blood test were normal. history--removal of gallbladder, removal of appendix, removal of 1 parathyroid (could not rule out hyperplaysia), 2014 -had a 7mm kidney stone removed, continue to have decreased kidney function and being treated for oxalates and low urine PH, borderline diabetic 5.7 A1C. On 10/21/2015 went to the emergency room for non stop vomiting and diarreah. CT with contrast showed several enlarged mesentery lymph nodes within the root of the mesentery radiating out into the lower abdomen. These have been seen on a previous CT scan 11/2014 --the nodes are more prominent than 2014 and seem relatively stable in number. The largest is in the left abdomen and measures 18x8 mm. The next largest node is in the left lower quadrant and measures 9x13mm. There is haziness of the fat of the root of the mesentery which is new compared to 2014. No obvious ad exam masses. Recommend follow up CT in 3 months. Blood test are normal, however tested positive for Mono on 10/30/2015 with EBV tests--EBV Ab to Viral Capsid Ag, IgG (range 0.0-21.9) 531, EBV Ab to Viral Capsid Ag, IgM (0.0-43.9) <10.0, EBV Ab to Neclear Ag, IgG (0.0-21.9) 125, EBV Ab to Early D Ag, IgG (0.0-10.9) 77.3. They did a TB test which was normal but I do question if it was done correctly. H-pylori Abs GA --Ab IgA(<=1.7) .80, Ab IgG(<=1.7) .30. Protein Electrophoresis Ab (3.30-4.80) 4.59, Alpha 1 (0.08-0.30) .19, Alpha 2 (0.50-1.05) .74, Beta (0.50-1.00) 0.63, Gamma (0.55-1.40) .075, Prot (6.0-8.4) 6.9, --within normal limits. Most blood test normal--low vitiman d, low hemoglobin, BUN at the top of the range. Bone Dexa scan indicated 9%-12% loss from 2012--osteopenia. I feel sick every day, recently constipated with severe back/spine pain, my tongue is sore with little bumps, headache and exhausted by mid day. My doctor doesn't know who I should see so I have scheduled and appointment with a GI who thinks I need an EGD and colonoscopy. Last EGD 12/2014-normal with GERD. Last colonoscopy 2008-normal. For the most part my weight loss has stabilized. I just feel ill and not sure who to see or if there really is nothing to worry about.
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Answered by Dr. Suresh Heijebu (13 hours later)
Brief Answer:
Ultrasound guided biopsy is needed.

Detailed Answer:
Hello Madam.

I can certainly understand your concerns.

I have worked through your query in detail.

This seems to be a relapsed form of Infectious Mononucleosis.

It is very important to rule out malignancy considering the size, and number and location of lymph nodes.

Malignancy particularly Hodgkins or Non Hodgkins lymphoma can occasionally arise from long standing IM.

Hence a CT or an Ultrasound guided biopsy is mandatory in your case.

Further management if any is based largely on the test reports.

Post your further queries if any.
Thank you.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Causes Severe Weight Loss With Nausea, Night Sweats And Cold?

Brief Answer: Ultrasound guided biopsy is needed. Detailed Answer: Hello Madam. I can certainly understand your concerns. I have worked through your query in detail. This seems to be a relapsed form of Infectious Mononucleosis. It is very important to rule out malignancy considering the size, and number and location of lymph nodes. Malignancy particularly Hodgkins or Non Hodgkins lymphoma can occasionally arise from long standing IM. Hence a CT or an Ultrasound guided biopsy is mandatory in your case. Further management if any is based largely on the test reports. Post your further queries if any. Thank you.