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What Do Elevated ESR Levels Along With Positive PPD Report Indicate?
Question: Last year 2015 in August I had floters in my eyes. Doctor said it's uvities and 3kg weight was lost. i had blood test and ESR level was 75mm/hr. I had done the x-ray of chest and a nodule on right side of the posterior wall was found. There was no other symptoms except eye problem. There was no fever, no cold and cough.I had a PPD test and it was positive. Doctor suspected it as a tuberocolesis. I continued the medicines from August to April. During this period i had done the chest x-ray, but the size of nodule was as it is. The ESR level was decreased to 25mm/hr. Doctor said it is not tuberocolesis. The nodule may present from childhood and refer to cardiology.
After completion of the medication, I did a blood test again in 4th XXXXXXX 2016. The blood report is as follows:
Haemoglobin:12.8gm
Patelet count: 2.78L
ESR: 40 mm/hr
Leucocyte count: 6.8
Neutrophils: 50%
Lymphocytes: 30%
Eosinophils: 13%
Basophils: 00%
Monocytes: 3%
Blood sugar FBS: 99 and PPBS: 104
I just want to know how can i control the ESR. Transparent Floters on eyes are there. No doctors able to tell the problem. What can i do?? Please suggest me...The blood test report and the details has been mentioned in the above section: medical Problems.
After completion of the medication, I did a blood test again in 4th XXXXXXX 2016. The blood report is as follows:
Haemoglobin:12.8gm
Patelet count: 2.78L
ESR: 40 mm/hr
Leucocyte count: 6.8
Neutrophils: 50%
Lymphocytes: 30%
Eosinophils: 13%
Basophils: 00%
Monocytes: 3%
Blood sugar FBS: 99 and PPBS: 104
I just want to know how can i control the ESR. Transparent Floters on eyes are there. No doctors able to tell the problem. What can i do?? Please suggest me...The blood test report and the details has been mentioned in the above section: medical Problems.
Brief Answer:
Possible SPN? Require HRCT chest
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
As per your radiological and clinical data, this should possibly reflect Solitary pulmonary Nodule/SPN.
This may or may not be of Tuberculous origin.
But an elevated ESR in conjunction with Positive PPT should suggest TB.
But at this point it's extremely important to confirm the findings.
For this, I advice you to get a HRCT scan of chest( High resolution CT scan) to document the possible cause of this Nodule.
Eye floaters require a direct visualization with Slitlamp biomicroscopy and Direct Ophthalmoscope.
Treating ESR should not be a prime agenda, rather detecting the cause of chest Nodule and Eye changes.
Get the scan and update the test results.
Also kindly let me know what medications have you used from August to April.
Post your further queries if any.
Thank you.
Possible SPN? Require HRCT chest
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
As per your radiological and clinical data, this should possibly reflect Solitary pulmonary Nodule/SPN.
This may or may not be of Tuberculous origin.
But an elevated ESR in conjunction with Positive PPT should suggest TB.
But at this point it's extremely important to confirm the findings.
For this, I advice you to get a HRCT scan of chest( High resolution CT scan) to document the possible cause of this Nodule.
Eye floaters require a direct visualization with Slitlamp biomicroscopy and Direct Ophthalmoscope.
Treating ESR should not be a prime agenda, rather detecting the cause of chest Nodule and Eye changes.
Get the scan and update the test results.
Also kindly let me know what medications have you used from August to April.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
I have done the CT scan two times and the first report the size was: 23*26*23mm and second it was 25*12*20mm. Doctor said it's nearly same and considered as no change.
I was taking medicine: R-cinexE (2tabs daily for 1st 2 months and then 1 tablet daily upto April 25th (1hr before dinner), VelozL , Benadon-40(half tablet daily).
Sir my question is whether the SPN and the ESR, Esnophils are related problem or different one. Because i usually sit in AC room most of the time. Is it the viral increases in blood or something else?
I have checked my eyes at LVprasad and they told me the floters will be disappear automatically.
From last week whenever i sleep under fan/cooler i feel a slight pain in my waist and feel a slight body temperature.
Now where should i go for consultation: Medicin specialist/ cardio thoracic/ Eye specialist.
Sir kindly suggest me. I am waiting for your kind suggestion.
I have done the CT scan two times and the first report the size was: 23*26*23mm and second it was 25*12*20mm. Doctor said it's nearly same and considered as no change.
I was taking medicine: R-cinexE (2tabs daily for 1st 2 months and then 1 tablet daily upto April 25th (1hr before dinner), VelozL , Benadon-40(half tablet daily).
Sir my question is whether the SPN and the ESR, Esnophils are related problem or different one. Because i usually sit in AC room most of the time. Is it the viral increases in blood or something else?
I have checked my eyes at LVprasad and they told me the floters will be disappear automatically.
From last week whenever i sleep under fan/cooler i feel a slight pain in my waist and feel a slight body temperature.
Now where should i go for consultation: Medicin specialist/ cardio thoracic/ Eye specialist.
Sir kindly suggest me. I am waiting for your kind suggestion.
Brief Answer:
Please upload CT scan reports
Detailed Answer:
Hi XXXX
it's very important for me to know the morphology of the SPN and dates of the CT scans.
I request you to kindly upload both the reports of the CT scans for me assess and guide you accurately further.
Yes, ESR, SPN and Eosinophils are related to each other.
Viral infection less likely.
Also upload the eye reports at LVPEI.
Based on the detailed analysis of these CT scans and Eye tests. I will guide you through, regarding the doctor which you need to attend.
Post your further queries if any.
Thank you.
Please upload CT scan reports
Detailed Answer:
Hi XXXX
it's very important for me to know the morphology of the SPN and dates of the CT scans.
I request you to kindly upload both the reports of the CT scans for me assess and guide you accurately further.
Yes, ESR, SPN and Eosinophils are related to each other.
Viral infection less likely.
Also upload the eye reports at LVPEI.
Based on the detailed analysis of these CT scans and Eye tests. I will guide you through, regarding the doctor which you need to attend.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir, I have uploaded the CT scan reports, blood test reports, and the recent eye test reports.
Kindly suggest me where should i go for treatment.
Kindly suggest me where should i go for treatment.
Brief Answer:
Go for biopsy.Consult a cardiothoracic surgeon.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have gone through the attached imaged in detail.
Your eye symptoms should be followed through periodic eye examination every 6 months.
With regards to CT scan it's very important to get a biopsy of the SPN, after consulting a cardiothoracic surgeon.
This biopsy is mandatory as there is no resolution with standard Anti Tuberculous therapy.
Once biopsy results are out , further management can be planned.
Post your further queries if any.
Thank you.
Go for biopsy.Consult a cardiothoracic surgeon.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have gone through the attached imaged in detail.
Your eye symptoms should be followed through periodic eye examination every 6 months.
With regards to CT scan it's very important to get a biopsy of the SPN, after consulting a cardiothoracic surgeon.
This biopsy is mandatory as there is no resolution with standard Anti Tuberculous therapy.
Once biopsy results are out , further management can be planned.
Post your further queries if any.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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