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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Enlarged Spleen, Lymph Nodes Under Arm, Neck And Salivary Glands, Feels Fatigued, Eye Sight Affected, Mild Fever, Hemangioma On Liver

Hi. Just a quick query if I may. I have a mildly enlarged spleen (14 1/2 cm) which I had for a while now, enlarged lymph nodes under left arm and in neck and salivary glands. Very fatigued also and eyesight affected. Fevers 38.9 but usually only at night. I am also on life long warfarin due to pe and dvts from some clotting abnormalities. My INR is currently 4.5 instead of the usual 2.3 (target) causing bruising and some bleeding. Had iron infusion 6 months ago due to very low mcv and some other stuff but blood work all fine with the exception of alp at 192. Further investigation suggests from liver not bone. Hemangioma on liver. Could my feeling so ill and these symptoms be due to the warfarin. I ve been on this drug for quite a number of years and just wonder if it s doing me more harm than good. The dr has put me on a second round of antibiotics even though the first course made no impact. Any ideas?
Tue, 29 May 2012
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Oncologist 's  Response
You have been on warfarin for DVT. You have to reduce the dose of warfarin to keep the INR in the range of 2.5 to 3. Yes brusiing on your skin is due to high INR.
Regarding your gland enlargement and fever you may be suffering from lymphoma. Please check with a competent physician or consult a Medical oncologist.possibly you need to have biopsy from the node after the infection is ruled out.
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Enlarged Spleen, Lymph Nodes Under Arm, Neck And Salivary Glands, Feels Fatigued, Eye Sight Affected, Mild Fever, Hemangioma On Liver

You have been on warfarin for DVT. You have to reduce the dose of warfarin to keep the INR in the range of 2.5 to 3. Yes brusiing on your skin is due to high INR. Regarding your gland enlargement and fever you may be suffering from lymphoma. Please check with a competent physician or consult a Medical oncologist.possibly you need to have biopsy from the node after the infection is ruled out.