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Multiple complaints and exposure to perchloroethylene

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I've been having several worrying symptoms for a while now. Here are the symptoms:

1- Night sweats.
2- Even though I did a Tonsillectomy in 2009, now every time I take a shower, I get a sore throat which is really annoying. One of my doctors said I have allergy and has been treating me with Fexofenadine/Loratadine, but it's not working anymore. I still get a sore throat every time I take a shower.
3- Very minor pain/discomfort in my knees and elbows.
4- Rash at my back as well as on upper legs.
5- Sometimes blurry vision.
6- Minor hair loss

You should know that I own a dry cleaning business. The solvent we use "Perchloroethylene" can cause many health problems if someone gets exposed to high concentrations.

Also, I spend lots of time on a desk behind my computer.

One last thing is that I recently went to a doctor and he gave me: Celecoxib (Celebrex) and Triamcinolone Acétonide (Obarcort) injections. They seem to relieve the knee and elbow discomfort.

According to the symptoms I have, can you tell me possible conditions I might be having. Also, can you give me a list of tests that I can do to narrow down the problem.

Thank you very much for your help.

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
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Thank you for asking your query at DoctorSpring.

I have discussed your concerns with Dr.Vivek Verma our occupational health expert. The symptoms you are experiencing are most likely unrelated to each other and to exposure to "Perchloroethylene". However you can discuss this concern with your Occupation and Safety officer in charge at your employer / local labour office.

Most likely tonsilectomy had been done because you might have had multiple episodes of very severe sore throat and to get rid of the sweeling and pain in the tonsils. Tonsillecomy can help only decrease the severity of sore throat episodes. It does not mean that you still will not have sore throats.

The current sore throat episodes are likely to allergic in nature from exposure to cold. You should try altering the time when you take bath and the temperature of the water. There is no point in taking anti allergy medication everytime you take a bath. Reserve it for severe symptoms. The occupations to PCE is know to cause sore throat, but the strong relationship with "bathing" suggest allergic etiology. You are most likely to have a chronic post pharyngeal wall inflammation. Have a steam inhalation twice day with open mouth. This should help

Other symptoms - blurry vision, hair loss, knee and elbow pain, rashes, and night sweats need evaluation. I recommend a set of baseline blood tests :

1. Complete blood count including Hb, ESR
2. Physical examination (including ophthalmologic examination)
3. Peripheral Blood smear
4. Renal/Liver function tests/Thyroid function tests
5. Urine Routine
6. Chest Xray.

All the tests are not mandatory. The required tests can be finalised after a physical examination.

Hope this helps
Please feel free to ask followup questions
Thank you

Patient replied :

Thank you very much for your advice. I tried steam inhalation as you suggested and it's definitely helping. I stopped taking all the medication now.

Here are the results of the tests you requested:

Note: The tests came in French, so I tried my best translating them into English.

Allergy test (Skin Prick Test)

They had 11 different allergens. None of them reacted except for the “positive witness” which showed a slight reaction. The doctor told me that the test is negative.


1st hour: 03 mm
2nd hour: 05 mm


HCV: 0.08 (negative)
HBV: negative
HIV: negative


Urea: normal
Creatinine: normal
AST: normal (36.40 UI/l)
ALT: normal (25.99 UI/l)
Alkaline phosphatase: normal (215.69 UI/l). Norm: 98 – 279 UI/l
Total Bilirubin: slightly elevated (13.07 mg/l). Norm: >11 mg/l


TSH us: normal
FT3: normal
FT4: slightly elevated (21.48 pmol/l). Norm: 10.6-19.4 pmol/l

Urine Routine

All the tests are negative.

Macroscopic aspect:
Urine color is light yellow.

Urine Chemistry:
PH = 06
Protein= Negative
Glucose= Negative
Ketone bodies= Negative
Blood= Negative
Leukocyte= Negative
Nitrite= Negative
Bilirubin= Negative
Urobilinogen= Negative
Density= 1.030

Microscopic aspect:
02 to 04 red blood cells/field
02 to 04 epithelial cells/field
02 to 04 Leukocytes/field
02 to 04 renal cells/field
Presence of uric acid crystals

Indirect examination:
After culture: absence of pathogens

Chest Xray.
The Chest Xray showed that everything is fine.

Blood count: Please see the file attached. Everything seems normal except: HGB, HCT, MCV, MCH which seem slightly elevated.

Please let me know whether these tests are enough for the diagnosis or if I need other tests.

Thank you very much. I appreciate your help.


Thank you for uploading the reports. Before making my comments I would like to know whether you smoke or consume alcohol on a regular basis (or used to in the past.)

Thank you

Patient replied :

I have never smoked or consumed alcohol before. I'm really careful when it comes to my health. I used to exercise on a regular basis, but now with the shower problem, it's making it hard for me to exercise regularly. I also try as much as I can eating healthy food.

Thank you


Well you results look fine. There is no major issues there. Although it is not diagnostic of any condition, it does rule out a large number of serious illness. All the symptoms except the sore throat should self resolve soon.

The sore throat most likely is allergic in nature, probably worsened by the PCE exposure. If the symptoms persists even after occasional anti allergic medication + general measures like steam inhalation you should consider visiting an ENT Surgeon.

Keep up with good diet and healthy lifestyle.

Wish you good health
Feel free to ask followups
Thank you

Patient replied :

Hello Doctor, I hope you're having a great day.

First of all, I wanted to thank you for your advice. Since I started steam inhalation as you suggested, I haven't gotten any sore throat whatsoever. You have no idea how grateful I am for this. It was a nightmare before each time I took a shower. Now I exercise regularly and shower without any problem, so thank you for that.

For the rest of the symptoms, I've been monitoring them to determine what's the cause. I realized that after a simple erection or even an ejaculation, my vision becomes blurry a little bit in addition to a very simple rash in my back or thighs that appears the next day (several small pink bumps + rarely a small blister). This rash starts to go away after 2-3 days, but sometimes it leaves marks. Also, each time I have and erection, even when I wake up in the morning, my thighs start to burn a little bit. Also, I go to the bathroom very often.

I've seen many Urologists before I contacted you the first time and they all told me the I have nothing + they gave me some antibiotics...etc.

You should know that I'm not married. I also don't get exposed to sun often because I work from home (I'm starting to change that because of the importance of vitamin D) + I get stressed easily so it's safe to say that I'm stressed most of the times.

I'm really confused about this. As you saw, All the tests came fine, so I don't really know what's the cause of this. I don't know if it's an infection, a hormonal problem or the exposure to Perchloroethylene or anything else. Please help me.

Thank you very much.


Glad to know that your symptoms are better. The blurry vision following ejaculation is nothing abnormal - its a normal body reaction in certain individuals. However the skin lesion, I am not sure what it is. But if it is not presisting you need not worry. A allergic reaction is one possibility. If possible send across an image of the lesion.

Hope this helps
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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