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Have Mildly High Bp, Weight Loss. ECG Normal. Urine Test, Liver Test And CBC Done. What Are The Findings?
Question: This query is for my father -68 years, overall health good, minor high BP 140 voice gets groggy sometimes, had no other issues except observable weight loss ( in general thin person). ECG, XR Normal
Attached are some reports and want to do Root Cause Analysis/ Diagnostics on anomalies found in CBC, Liver test and minor X XXXXXXX comments.
I) CBC REPORT -
Haemoglobin = 11.7
RBC = 4.1
PCV 34.8
WBC= 16.8
Neutrophils, Eosonophils, Basophils within range
Lymphocytes = 56
MCV = 83.05
MCH = 27.92
MCHC = 33.62
Platelet Count = 2.1 ( X 10 to the power of 5/cmm)
Peripheral Smear Pathological lab comment =
RBC = Pathological lab comment Hypochromacia Mild,
WBC= Pathological lab comment = Leucocytosis with Lymphocytic dominance
Platelets : lab comment adequate on smear but few platelets aggregates seen
ESR = 90
II) Urine Test - minor trace of occult blood in urine, Stool test = Normal
III) LIVER TEST
A) Low S. GPT (byenzymatic method) = 28 ( normal between 30 -65)
B) High S.GGTP ( byenzymatic method) = 6 ( normal between 15-85)
C) S. Albumin (Bybromocresol purple method( = = 3.2 ( normal between 3.5 - 5)
D) S. Globulin = 4.2 ( Normal between 1.8 - 3.6)
E) A/G Ratio = 0.76 ( Normal between 1.5-3.5)
III) XRAY PATHOLOGICAL LAB COMMENTS
X XXXXXXX
Bilateral peri hilar congestion is noted.
The rest of the visualised lung fields are clear.
The heart shadow appears normal.
The aortic knuckle is prominent.
Both costophrenic angles and cardiophrenic angles are clear.
Both domes of the diaphragm are normal.
The thoracic rib cage appears normal.
IMPRESSION:
Bilateral perihilar congestion.
Clinical corelation is suggested.
Attached are some reports and want to do Root Cause Analysis/ Diagnostics on anomalies found in CBC, Liver test and minor X XXXXXXX comments.
I) CBC REPORT -
Haemoglobin = 11.7
RBC = 4.1
PCV 34.8
WBC= 16.8
Neutrophils, Eosonophils, Basophils within range
Lymphocytes = 56
MCV = 83.05
MCH = 27.92
MCHC = 33.62
Platelet Count = 2.1 ( X 10 to the power of 5/cmm)
Peripheral Smear Pathological lab comment =
RBC = Pathological lab comment Hypochromacia Mild,
WBC= Pathological lab comment = Leucocytosis with Lymphocytic dominance
Platelets : lab comment adequate on smear but few platelets aggregates seen
ESR = 90
II) Urine Test - minor trace of occult blood in urine, Stool test = Normal
III) LIVER TEST
A) Low S. GPT (byenzymatic method) = 28 ( normal between 30 -65)
B) High S.GGTP ( byenzymatic method) = 6 ( normal between 15-85)
C) S. Albumin (Bybromocresol purple method( = = 3.2 ( normal between 3.5 - 5)
D) S. Globulin = 4.2 ( Normal between 1.8 - 3.6)
E) A/G Ratio = 0.76 ( Normal between 1.5-3.5)
III) XRAY PATHOLOGICAL LAB COMMENTS
X XXXXXXX
Bilateral peri hilar congestion is noted.
The rest of the visualised lung fields are clear.
The heart shadow appears normal.
The aortic knuckle is prominent.
Both costophrenic angles and cardiophrenic angles are clear.
Both domes of the diaphragm are normal.
The thoracic rib cage appears normal.
IMPRESSION:
Bilateral perihilar congestion.
Clinical corelation is suggested.
Hi
Thanks for your query.
From the above reports, it seems that your father has some underlying subclinical infection or inflammation. This is causing the leukocytosis with lymphocytic predominance. ESR is raised due to the same reason. The same process is causing serum globulins to be raised in contrast to serum albumin levels.
He is also suffering from anemia. It can be due to iron deficiency or a chronic disease.
He seems to be malnourished from his serum albumin levels. Low SGPT and SGOT are suggestive vitamin deficiency (especially vit B6) or previous history of alcohol intake.
The perihilar congestion on chest x-ray may be seen when heart fails to pump blood effectively into circulation.
Mostly in elderly people, many concerns need to be addressed at the same time. Elderly people sometimes fail to take care of themselves and may suffer from malnourishment as a result.
As your dad is losing weight, it is recommended that he takes 3 proper meals and 3 small meals in a day. You can also add nutritional supplements to his diet. It will give him energy to keep fighting other health conditions. It is also recommended that he takes iron and multivitamin supplements along with the diet.
Please consult a physician to correlate these findings clinically.
Hope I helped. Let me know if I can assist you further.
Dr Vaishalee Punj
Thanks for your query.
From the above reports, it seems that your father has some underlying subclinical infection or inflammation. This is causing the leukocytosis with lymphocytic predominance. ESR is raised due to the same reason. The same process is causing serum globulins to be raised in contrast to serum albumin levels.
He is also suffering from anemia. It can be due to iron deficiency or a chronic disease.
He seems to be malnourished from his serum albumin levels. Low SGPT and SGOT are suggestive vitamin deficiency (especially vit B6) or previous history of alcohol intake.
The perihilar congestion on chest x-ray may be seen when heart fails to pump blood effectively into circulation.
Mostly in elderly people, many concerns need to be addressed at the same time. Elderly people sometimes fail to take care of themselves and may suffer from malnourishment as a result.
As your dad is losing weight, it is recommended that he takes 3 proper meals and 3 small meals in a day. You can also add nutritional supplements to his diet. It will give him energy to keep fighting other health conditions. It is also recommended that he takes iron and multivitamin supplements along with the diet.
Please consult a physician to correlate these findings clinically.
Hope I helped. Let me know if I can assist you further.
Dr Vaishalee Punj
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr Vaishalee Punj
Thank you for your prompt response. 3 clarifications are still remaining if you could trhow light on them -
1. You don't see any bone marrow or blood disorder issues, right? Kindly clarify.
2. Also what do you think could be the causes and remedies for Bihilar congestion?
3. Platelet aggregation in the smear report - what could be the causes and remedy for that?
Ma'am - as a follow up to my previous 3 questions, please also explain how can we determine where the infection/inflammation is and what are the remedies for the same?
Lastly what is the meaning, causes and remedy for occult blood trace in urine report. is that minor?
For any of the above, any more tests required?
Can you tell us where you are practicing - India or US? Kindly give contact details too.
Thanks again
XXXXXX
Thank you for your prompt response. 3 clarifications are still remaining if you could trhow light on them -
1. You don't see any bone marrow or blood disorder issues, right? Kindly clarify.
2. Also what do you think could be the causes and remedies for Bihilar congestion?
3. Platelet aggregation in the smear report - what could be the causes and remedy for that?
Ma'am - as a follow up to my previous 3 questions, please also explain how can we determine where the infection/inflammation is and what are the remedies for the same?
Lastly what is the meaning, causes and remedy for occult blood trace in urine report. is that minor?
For any of the above, any more tests required?
Can you tell us where you are practicing - India or US? Kindly give contact details too.
Thanks again
XXXXXX
Hi
Here we need to understand that red blood cells are formed in bone marrow.
Hemoglobin is low and packed cell volume is a little low. It may mean that less number of red blood cells is being formed in the bone marrow. It may mean iron deficiency or anemia of chronic disease.
Platelet aggregation in report can be due to a tendency of thrombosis.
Blood trace in urine can be an indication of infection or obstruction in urinary tract. If rest of urinalysis is normal, then this isolated finding can be ignored.
Perihilar congestion can be due to insufficient pumping of blood by heart. If ECG is normal, then you may consult your physician about what else can be done to assess cardiac function. The tests may include echocardiography, treadmill-ECG, etc.
Infections and inflammations usually present with signs and symptoms specific to the site of infection. In elderly, the symptoms may not be as specific due to frail body. Further investigations are based on the symptoms present.
Currently I will worry about weight of your dad and do more investigations if any symptoms show up.
I have worked in Canada and India.
Currently I am working in India.
For security reasons I cannot provide my contact details.
The link to my profile on XXXXXXX is:
WWW.WWWW.WW
Regards
Here we need to understand that red blood cells are formed in bone marrow.
Hemoglobin is low and packed cell volume is a little low. It may mean that less number of red blood cells is being formed in the bone marrow. It may mean iron deficiency or anemia of chronic disease.
Platelet aggregation in report can be due to a tendency of thrombosis.
Blood trace in urine can be an indication of infection or obstruction in urinary tract. If rest of urinalysis is normal, then this isolated finding can be ignored.
Perihilar congestion can be due to insufficient pumping of blood by heart. If ECG is normal, then you may consult your physician about what else can be done to assess cardiac function. The tests may include echocardiography, treadmill-ECG, etc.
Infections and inflammations usually present with signs and symptoms specific to the site of infection. In elderly, the symptoms may not be as specific due to frail body. Further investigations are based on the symptoms present.
Currently I will worry about weight of your dad and do more investigations if any symptoms show up.
I have worked in Canada and India.
Currently I am working in India.
For security reasons I cannot provide my contact details.
The link to my profile on XXXXXXX is:
WWW.WWWW.WW
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you
Hope I helped.
Please close the query if you have no more questions.
Thanks for posting on XXXXXXX
Dr Vaishalee Punj
Please close the query if you have no more questions.
Thanks for posting on XXXXXXX
Dr Vaishalee Punj
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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