Should You See a Hematologist for Recurrent Oral Ulcers and Fatigue?

Blood test

Hello, doctor.
I have recurrent oral ulcers and dermatitis on my scalp.
Sometimes I experience blurred vision and joint pain, but it doesn't significantly affect my daily life.
I would like to get tested for Behçet's disease.
Additionally, I occasionally feel dizzy and have low energy with excessive sleepiness, so I would also like to check for anemia.
Should I see a hematologist?

Ye, 20~29 year old female. Ask Date: 2018/09/09

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Yeh,
In your letter, you mentioned experiencing recurrent oral ulcers and other symptoms, raising concerns about the possibility of Behçet's disease.
I recommend that you consult a rheumatologist for a comprehensive evaluation to clarify the underlying issues.
Additionally, with symptoms of dizziness, fatigue, and excessive sleepiness, there may be a suspicion of anemia.
It would be advisable to have your physician conduct a complete blood count and iron studies for diagnosis.
Sincerely,
Dr.
Chen Po-Chang
Department of Family Medicine
Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2018/09/09

More Info

Based on your symptoms and concerns, it is indeed advisable to consider consulting a hematologist, especially given your recurrent oral ulcers, fatigue, and other systemic symptoms such as joint pain, occasional blurred vision, and dizziness. These symptoms can be indicative of various underlying conditions, including autoimmune disorders, hematological issues, or even systemic diseases like Behçet's disease, which you mentioned.

Behçet's disease is a rare autoimmune condition characterized by recurrent oral and genital ulcers, skin lesions, and ocular inflammation. It can also affect joints and cause systemic symptoms. The presence of recurrent oral ulcers, along with your other symptoms, raises the possibility of an autoimmune process, and a hematologist can help evaluate for conditions such as Behçet's disease or other related disorders.

In addition to consulting a hematologist, it may be beneficial to see a rheumatologist, as they specialize in autoimmune diseases and can provide a comprehensive evaluation of your symptoms. They may perform specific tests to check for inflammatory markers, autoimmune antibodies, and other relevant blood tests to rule out conditions like lupus, rheumatoid arthritis, or other connective tissue diseases.

Regarding your concerns about anemia, fatigue, and dizziness, these can be related to several factors, including nutritional deficiencies (such as iron, vitamin B12, or folate), chronic inflammation, or hematological disorders like anemia of chronic disease. A hematologist can conduct blood tests to assess your complete blood count (CBC), iron studies, and other relevant parameters to determine if you have anemia and its potential causes.

It's also important to consider lifestyle factors that may contribute to your symptoms. Stress, poor nutrition, and lack of sleep can exacerbate fatigue and immune responses, potentially leading to increased susceptibility to infections and ulcers. Therefore, addressing these factors through lifestyle modifications, such as improving your diet, managing stress, and ensuring adequate rest, can also be beneficial.

In summary, given your complex symptoms, it is advisable to consult both a hematologist and possibly a rheumatologist. They can work together to evaluate your symptoms comprehensively, conduct necessary tests, and provide a diagnosis and treatment plan tailored to your needs. Early intervention and proper management can significantly improve your quality of life and help you find relief from your symptoms.

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