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What does the blood report indicate?

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Posted on Wed, 27 May 2015
Question: Hi
My wife had an episod of chills/ night sweats. She is complaining about slight pain all over the body.

Her recent tests are as below:

WBC - 12.9 x10 9/L*

Neut - 9.4 x10 9/L*

Eos - 0.8 x10 9/L*

ESR - 34 mm/hr*

Complement C3 - 1.5 g/L

Complement C4 - 0.62 g/L*

CRP - 6.2 mg/L*

Iron - 7 umol/L*

T. Sat - 8%*

Other tests are either in normal range or negative.

Pleasesuggest the likely cause of such abnormalities. What should be the next set of tests to be performed?

I have attached further tests. LFT, sugar etc. Can I confirm that the C4 complement is decreased as the result suggest otherwise with the value of 0.62 g/L with normal range ( 0.12 - 0.36)

Also the doctor has suggested to see a rheumatologist and possibly get a bone marrow biopsy. Could this be suggestive of any serious health condition?

Please help.
doctor
Answered by Dr. Shruti Rijhwani (54 minutes later)
Brief Answer:
She needs further evaluation.

Detailed Answer:
Dear Sir,

Thank you for posting your query on HCM.

Well looking into your query I will like to tell you that there is nothing much severe abnormality in the investigations that you have provided .

Fever with chills generally present with bodyaches and is mostly due to infectious cause or viral etiology. Further urine r/m , blood c/s , Peripheral smear for malarial parasite, widal test should be done .

Also please give detailed history so that we can guide you further like any history of rashes , joint swelling, recurrent oral ulceration , genital ulceration, photosensitivity , recurrent abortions so that we can understand the disease better and guide you further . Also mention if your wife had any history of recurrent abortions so that we can evaluate for any rheumatological cause .

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (1 hour later)
Thanks for the response.
She had no history of rash or joint swelling. No history of ulceration either. She is having travelling pain under the skin all over, just not near the joints.
She did had one ectopic pregnancy and methotrexate was given in hospital around 4 years back.

I am but concerned about the raised C4 levels and the fact that the doctor has suggested possible bone marrow biopsy?

Regards



doctor
Answered by Dr. Shruti Rijhwani (4 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

Thank you for reverting back.

Well I dont see a reason to worry regarding complement levels . Bone marrow biopsy is routinely prescribed in fevers of unknown origin to make a diagnosis , since all her investigations are more or less normal thats why they would have considered bone marrow biopsy .

Some autoimmune diseases like SLE can have similar presentation but as if now you dont give any history for the same still if you want ANA testing can be done to rule this out.

Dr. Shruti


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (7 minutes later)
Ok thanks.

Attached with the results is ANA which came out to be negative.

One thing I forget to mention. She did have stomach ulcers lasted for few months last years. She also had throat ulcers few months back for which she took antibotics.
one thing to note that the WBC were also high in the last test did last year.?

Regards
doctor
Answered by Dr. Shruti Rijhwani (15 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

Thank you for reverting back.

Since the ANA is negative , the risk of LUPUS is negligible , since she had oral ulceration your treating doctor would be suspecting for lupus but I dont think it is significant as if now .

Mild WBC elevations are not significant so as if now I dont think there is much to further investigate for .

Any other concerns please feel free to ask.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (4 minutes later)
Ok. To put it straight. Do you there is a risk of something serious like lukemia. The high c4 levels and wbc levels and the need for bone marrow biopsy seems to indicate that. I hope I am wrong but wanted your view point

Thanks
doctor
Answered by Dr. Shruti Rijhwani (7 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

The report of WBC count that you have sent me is approx 12900/cumm whereas the normal range is 4000 - 11000 /cumm . If these facts are right then there is no fear of leukemia by this report . In leukemia the counts are extrememly high like above 50000/cumm normally . So I dont think so that there is a chance for leukemia .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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What does the blood report indicate?

Brief Answer: She needs further evaluation. Detailed Answer: Dear Sir, Thank you for posting your query on HCM. Well looking into your query I will like to tell you that there is nothing much severe abnormality in the investigations that you have provided . Fever with chills generally present with bodyaches and is mostly due to infectious cause or viral etiology. Further urine r/m , blood c/s , Peripheral smear for malarial parasite, widal test should be done . Also please give detailed history so that we can guide you further like any history of rashes , joint swelling, recurrent oral ulceration , genital ulceration, photosensitivity , recurrent abortions so that we can understand the disease better and guide you further . Also mention if your wife had any history of recurrent abortions so that we can evaluate for any rheumatological cause . Take care. Dr. Shruti