Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Multiple diagnostic tests and still no answers.Hi there! I am just looking for any answer, preferably from someone who has a background in hematology? I am a 29 year old female, and was hospitalized for an unknown illness in April (fever, chills, all over body aches). The doctors ran many tests (HIV, mono, Covid, Flu, RSV, blood cultures, abdominal CT, pelvic exam, pelvic ultrasound, CBC tests, etc.) and still were not able to find what was causing my symptoms. I worked with an internal medicine specialist after my hospitalization because I continued to get sick and have fevers every couple of weeks until July. She ended up testing me for many infectious diseases and they were negative (with the exception of EBV, but this didn't look like something new). Also tested me for an ANA marker (negative). Her biggest concern were my elevated platelets and WBC. She noticed these had been elevated for >6 months. I had a peripheral blood smear and saw slight leukocytosis with left-shifted neutrophilia and monocytosis, slight thrombocytosis with normal platelet morphology. No abnormal circulating cell populations identified.She referred me to a hematologist who I have been working with but still no answers. The hematologist tested me for a JAK2 mutation (negative), CALR mutation (negative), BCR-ABL (negative), and redid my CBC count. She had been thinking potentially essential thrombocythemia (ET). This time my reticulocytes are elevated and my circulating antibodies are elevated. I do not have an iron deficiency. My WBC and platelets continue to be elevated and they ran another peripheral blood smear with similar findings. Everything seems to point to "favor reactive/inflammatory". However, in looking through my historical lab reports, we can see this blood work has actually been a pattern for the past 9 years! I have begged her to do a bone marrow biopsy just to triple check for ET or other MPNs because it seems that about 50% of patients with ET have no genetic mutation but she said no. I just feel like I need to know why my bone marrow is pumping out immature blood cells and extras of others. Now she's referring me to a rheumatologist and I don't understand why except that I may have chronic inflammation. I have no joint/muscle/bone pain, my ANA marker test was negative. Could it potentially be something like autoimmune hemolytic anemia since my reticulocytes are elevated and antibodies?I'm just so tired of being dismissed by doctors over the years and not having answers. I am so exhausted all the time. I just want someone else to give me another opinion or potential ideas for new avenues to explore. I am following up with the hematologist in January and have an appointment with a rheumatologist that same week, hoping to get in earlier if someone cancels.Thank you so much in advance.. ### Response: Were you tested for a mutation in a gene called MPL?Does your peripheral blood still show a left shift, or has that resolved?.