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Had swelling in ankles and legs, bilateral, with rash tender to touch and gained weight. Done CBC test. Findings?

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General & Family Physician
Practicing since : 2007
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I have had swelling in the ankles and legs, bilateral, with a rash lookiing condiition on the lower ankles and legs. The area with the rash was tender to the touch. The rash has decreased but the swelling has not gone away. I have also gained several pounds as well, even though I am dieting ( 900 calories). My doctors office did a CBC Test and it showed this:
Tests: (1) CBC W/ AUTO DIFF (0000)
WBC [L] 3.5 K/uL 4.0-10.0
RBC 4.30 10^6/uL 4.20-5.40
HGB 12.3 g/dL 12.0-16.0
HCT [L] 36 % 37-47
MCV 83.6 fl 81.0-99.0
MCH 28.7 pg 28.0-32.0
MCHC 34.3 g/dL 32.0-36.0
RDW 14.1 % 11.5-14.5
PLT 168 K/uL 150-450
MPV 7.4 fL 6.0-9.5
NEUT% 64.6 % 37.0-80.0
LYMPH% [L] 18.3 % 20.5-51.1
MONO% [H] 13.1 % 1.7-9.3
EOS% 3.1 % 0.0-6.0
BASO% 0.9 % 0.0-2.0
NEUT# 2.2 K/uL 1.6-7.7
LYMPH# [L] 0.6 K/uL 1.2-3.4
MONO# 0.5 K/uL 0.0-1.0
EOS# 0.1 K/uL 0.0-0.7
BASO# 0.0 K/uL 0.0-0.1

Sodium 134 mmol/L 134-144
Potassium 4.1 mmol/L 3.3-5.0
Chloride [L] 96 mmol/L 98-109
CO2 31 mmol/L 24-34
Glucose, Blood 92 mg/dL 70-110
BUN 7 mg/dL 6-20
Creatinine, Serum 0.82 mg/dL 0.45-1.17
Calcium 9.7 mg/dL 8.7-10.0

Tests: (3) C REACTIVE PROTEIN (0000)
C-Reactive Protein [H] 1.97 mg/dL 0.02-0.70
What would be your suggestion?
Posted Tue, 8 Oct 2013 in Medicines and Side Effects
Answered by Dr. Lohit K 1 hour later
Brief Answer:
Suggests inflammation.Few investigations required.

Detailed Answer:
Hi XXXXX thanks for using XXXXXXX
I can understand your concern.

Based on your history and your investigation reports I like to give my suggestions.

1. Lower limbs swelling and rash with tender to the touch along with raised in C-Reactive Protein (1.97 mg/dL) and raised monocytes levels suggests inflammation. The inflammation may be due to allergy or micro organisms. Your differential count has not shown any raise in TC or neutrophils. This suggest there is no current microbial infection.

For other parameters (investigation), you need not to worry. They are in normal range and few variations of others are acceptable.

2. For diagnosing the bilateral pedal edema and weight gain (Bilateral edema usually occurs due to systemic cause) considering your history and age I advice you to get checked for LFT, TSH, cardiac evaluation and USG abdomen and pelvis once. This will help us to rule out any major problem

3. For now you need anti inflammatory drugs for managing current inflammation, keep your legs in higher elevated levels while resting, do mild walking and keep the skin in aseptic condition using antiseptic solution. Consult your doctor for further examination and management.

I hope this information has been both informative and helpful for you. Feel free to ask me if you have any further queries.

Wish you good health. Take care.

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