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Enlarged neck lymph nodes for evaluation.

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Hi doc, Currently i have swollen lymph nodes in neck and arm pits, mouth burning like anything all the time on the lateralside of tongue, apthous mouth ulcers inside both cheeks, lymphadenitis, pain in b/l arm pits and in the scapular region, pectoral region.......no other symptoms............such as fever, headache, diarrhea, skin rash..........

ON 11/28/12 HSV 1 Ig G levels are 3.76...............and Hiv icma test was NEGATIVE;

ON 12/07/12 HIV RNA qualitative test was NEGATIVE...........

ON 02/15/13 HSv 1 IG g levels are 3.38 and HIV icma and Hiv rna QUALITATIVE TEST are NEGATIVE;

ON 07/03/13 HSV 1 IG g levels are 4.02 and HIV icma and HIV rna qualitative negative............

ON 01/06/14 HSV 1 IG levels are 3.62 and HIV icma and HIV rna qualitative test negative..........

ON 01/11/14 my CD4:CD8 profile ratio................. I had my CD4 and CD8 counts run:

Absolute CD4 helper: 879 (range 359-1519)
% CD4 Pos. Lymph: 31.4 (range 30-58)
Absolute CD8 suppressor: 1204 *HIGH* (range 109-897)
% CD8 Pos. Lymph: 43.0 *HIGH* (range 12-35)
CD4/CD8 Ratio: 0.73 *LOW* (range 0.92-3.72)
My other STD tests are negative on the following dates respectively 11/28/12, 02/15/13, 07/03/13, 01/06/14...........
Why my Absolute CD8 suppressor cells are high?
Why my % CD8 Pos. Lymph cells are high?
Why my CD4/CD8 Ratio is low?
Plz interpret the results................................i am worried too much................

Category: HIV- AIDS Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for choosing DoctorSpring.
I understand your concern and will try my best to help you here.

You have negative STD tests and repeated negative HIV test. Your concern is about the CD8 levels. I am not sure why your Doctor ordered for these tests in the first place. If there was a specific indication please let me know. A very important fact you need to understand is (a misconception lot of people have) that CD4 and CD8 Suppressor cells are NOT all about HIV. They are very dynamic functional component in the human body. From change of temperature to a simple viral illness lot of factors can influence their levels.

In you care the Absolute CD8 suppressor levels are high normal. I will not call it abnormal. Without other correlating or supporting lab finding this has not meaning. Infact this means your immune system is working. These cells are supposed to go up and down. Same with Lymphocytosis. The CD4/CD8 ratio is low because of the relatively high CD8 Count.

I would like to know whether you have done baseline blood tests (Complete Count ), Peripheral Smear etc.
Also was the Lymph node enlargement diagnosed by your Doctor ? If so was it evaluated further ?
May I know the indication for CD4 testing. If it was a self ordered test may I know what prompted you ?

Hope this helped
Thank you

Patient replied :

All these are self ordered tests, lymphadentitis, apthous ulcers are diagnosed by the doctor. CD4/CD8 count test was done along with complete blood count......then why I am having these symptoms...........

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

CD4 and CD8 levels should not be done as a routine as it will not give any useful information. The symptoms seem to be discrete. Aphthous can occur without a cause. You can use a Chlorhexidine containing mouthwash for this. Also take a B complex vitamin.

Lymph Node enlargement is what requires evaluation. If it persisting for more than 2 weeks you need to do a Peripheral Smear examination (a blood test) followed by a course of antibiotics.

Anyway your are HIV negative and need not repeat the tests. The next evaluation should be step by step and it is better done step by step.

Hope this helps
Thank you

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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