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What Do The Following Lab Test Reports Indicate?
Question: MY recent labs show ALK PHOS 131 and ALT 47, SED RATE 132. I do have some upper right and left abdominal pains. Have been feeling malaise for past two weeks. History of gallstones. Still have gallbladder. Achy all over. Swollen/tender neck lymph nodes. Sweats/chills.
Brief Answer:
sed rate high so need blood smear..
Detailed Answer:
Hello there.
You seem to have white cell mass( its invasive nature can only be detected with whole body PET scan)..Early diagnosis can help prevent future ailments..Get checked the below.
1)Hemoglobin
2)WBC count ( total and differential)
3) Platelet count.
4) PCV and MCV
5)ultrasound Abdomen
For time being I suggest you to take ultracet tablet thrice a day for a week..
Reply back with reports.Further management will depend on reports as well as your progress.
Take care
sed rate high so need blood smear..
Detailed Answer:
Hello there.
You seem to have white cell mass( its invasive nature can only be detected with whole body PET scan)..Early diagnosis can help prevent future ailments..Get checked the below.
1)Hemoglobin
2)WBC count ( total and differential)
3) Platelet count.
4) PCV and MCV
5)ultrasound Abdomen
For time being I suggest you to take ultracet tablet thrice a day for a week..
Reply back with reports.Further management will depend on reports as well as your progress.
Take care
Above answer was peer-reviewed by :
Dr. Raju A.T
What do you mean by ' white cell mass'? Do you mean cancer or something else? I have lab results for:
hemoglobin 11.6 (low)
rbc 3.73 (low)
MCH 31.1 (normal)
MCV 94.8 (normal)
Platelet 250 (normal)
do not see PCV
Had abdominal Ultrasound about four months ago I think, don't have results with me. But, I remember them telling me all normal except presence of gallbladder sludge and stones. No inflammation or wall thickening.
I do take pain medication from pain mgt doctor for back disc herniations from an accident.
Regarding the blood smear, I did have one about 10 years ago for then leukopenia and it did show rouleaux formation. I had bone biopsy done with slight presence of plasma cells. I followed with a hematologist for several years after, but no further leukopenia, so nothing else done. I do still see hematologist for continuing anemia. In fact, I see her this Friday. Is there anything I need to ask her in your opinion?
I just saw rheumatology specialist last week for possible lupus due to my elevated SED rate. He said no lupus, negative ANA. He ordered CT/Angio of chest/abd/pelvis for possible vasculitis or malignancy. Does this sound right to you? Is there anything else I need to be concerned about?
Thank you..
hemoglobin 11.6 (low)
rbc 3.73 (low)
MCH 31.1 (normal)
MCV 94.8 (normal)
Platelet 250 (normal)
do not see PCV
Had abdominal Ultrasound about four months ago I think, don't have results with me. But, I remember them telling me all normal except presence of gallbladder sludge and stones. No inflammation or wall thickening.
I do take pain medication from pain mgt doctor for back disc herniations from an accident.
Regarding the blood smear, I did have one about 10 years ago for then leukopenia and it did show rouleaux formation. I had bone biopsy done with slight presence of plasma cells. I followed with a hematologist for several years after, but no further leukopenia, so nothing else done. I do still see hematologist for continuing anemia. In fact, I see her this Friday. Is there anything I need to ask her in your opinion?
I just saw rheumatology specialist last week for possible lupus due to my elevated SED rate. He said no lupus, negative ANA. He ordered CT/Angio of chest/abd/pelvis for possible vasculitis or malignancy. Does this sound right to you? Is there anything else I need to be concerned about?
Thank you..
Brief Answer:
Not to worry until anything is proven.Repeat smear..
Detailed Answer:
Hello again
The labs are quite normal except as you said Esr-132 and borderline anemia..
Yes,I agree with your hematologist's perspective of imaging (CT angio) because there are many aetiologies for the complaints mentioned I.e benign vasculitis to invasive malignancy.
Based on the history and labs, I suspect multiple myeloma or polycythemia vera ...Immunohistochemistry analysis will be helpful to find out the pathology in the lineage..
The chills may indicate the presence of immature blast cells in the periphery..
Avoid polluted environment and maintain good personal hygiene..
1)Do you have any bone pain on palpation
2)Any recent urinalysis report ?
In both the cases, bone transplant is the permenant cure modality though..I didn't scare you but make you cautious.
Wish you good health
I am happy to clear your doubt's in future too.
Not to worry until anything is proven.Repeat smear..
Detailed Answer:
Hello again
The labs are quite normal except as you said Esr-132 and borderline anemia..
Yes,I agree with your hematologist's perspective of imaging (CT angio) because there are many aetiologies for the complaints mentioned I.e benign vasculitis to invasive malignancy.
Based on the history and labs, I suspect multiple myeloma or polycythemia vera ...Immunohistochemistry analysis will be helpful to find out the pathology in the lineage..
The chills may indicate the presence of immature blast cells in the periphery..
Avoid polluted environment and maintain good personal hygiene..
1)Do you have any bone pain on palpation
2)Any recent urinalysis report ?
In both the cases, bone transplant is the permenant cure modality though..I didn't scare you but make you cautious.
Wish you good health
I am happy to clear your doubt's in future too.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi, 1) I had urinalysis done few months ago and was all normal.
2) No bone pain. Although I have many tender points on joints/muscles probably due to fibromyalgia.
Don't think polycythemia vera fits for me as none of my CBC numbers are elevated. In fact, rbc and hemoglobin is low with chronic anemia. I do have sensitive/reddened skin on arms and face though.
I have had some ANA tests come back positive, never more than 1:160 titer, but latest one came back negative. I have swollen and tender cervical nodes which this past year has come and gone a few times. Usually has cleared with antibiotics. Also, over past year I have had a few bouts of 'peritonitis'. A feeling of bloating, with pain like organs are swollen and rubbing. This usually lasts a few weeks then disappears.
My SED rate started elevating 5 years ago, highest around 50-60. This year has gotten into the hundreds with this latest my highest at 132.
I have seen few different specialists. No one seems to be able to pin down.
Do you think this could be from gallbladder? I have had sludge and stones for several years. I am chicken to go thru surgery to have it removed:)
The only other thing I found looking back thru my labs is 10/2014 my gastric parietal cell ab were high at 29.2 Not really sure if this is important.
Just scared I have cancer. Any other tests you recommend or other ideas?
2) No bone pain. Although I have many tender points on joints/muscles probably due to fibromyalgia.
Don't think polycythemia vera fits for me as none of my CBC numbers are elevated. In fact, rbc and hemoglobin is low with chronic anemia. I do have sensitive/reddened skin on arms and face though.
I have had some ANA tests come back positive, never more than 1:160 titer, but latest one came back negative. I have swollen and tender cervical nodes which this past year has come and gone a few times. Usually has cleared with antibiotics. Also, over past year I have had a few bouts of 'peritonitis'. A feeling of bloating, with pain like organs are swollen and rubbing. This usually lasts a few weeks then disappears.
My SED rate started elevating 5 years ago, highest around 50-60. This year has gotten into the hundreds with this latest my highest at 132.
I have seen few different specialists. No one seems to be able to pin down.
Do you think this could be from gallbladder? I have had sludge and stones for several years. I am chicken to go thru surgery to have it removed:)
The only other thing I found looking back thru my labs is 10/2014 my gastric parietal cell ab were high at 29.2 Not really sure if this is important.
Just scared I have cancer. Any other tests you recommend or other ideas?
Brief Answer:
Get CT done;awaiting for reports
Detailed Answer:
Hello XXXX
Thank you for writing back..
Not to worry until anything is proven.
I don't think its directly connected with gall bladder/stones.
Increasing ESR over years alone do not necessarily be related to cancer or with your complaints of right and left hypochondriac region pain.
Get CT angio of chest,abdomen,pelvis as advised.Further management will depend on those reports.
For malaise,as of now no need for any medications..encourage fresh juices and boiled vegetables..You can take ultracet tablet for generalized myalgia under supervision
You can also update me with reports in the page @ bit.ly/Dr-Senduran
Get CT done;awaiting for reports
Detailed Answer:
Hello XXXX
Thank you for writing back..
Not to worry until anything is proven.
I don't think its directly connected with gall bladder/stones.
Increasing ESR over years alone do not necessarily be related to cancer or with your complaints of right and left hypochondriac region pain.
Get CT angio of chest,abdomen,pelvis as advised.Further management will depend on those reports.
For malaise,as of now no need for any medications..encourage fresh juices and boiled vegetables..You can take ultracet tablet for generalized myalgia under supervision
You can also update me with reports in the page @ bit.ly/Dr-Senduran
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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