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Dr. Andrew Rynne

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What does this blood report indicate?

Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1480 Questions

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Posted on Tue, 4 Apr 2017 in Blood Disorders
Question: Hello,

I am a 25 year old male of mixed raced origin (African black father, white mother) worried that I may have Multiple Myeloma. I have been having symptoms of fatigue, mild back pain for the past few weeks, urinary frequency, breathlessness(this seems to have stopped).

Prior to my urinary frequency I had been drinking creatine shakes which showed an elevated creatinine level when I had blood tests. They were something like a 1.6 and since then I have stopped drinking the shakes and it has come down slowly to 1.12 in under a month. Private healthcare specialist wasn't worried about this as he saw a gradual drop in consecutive blood tests.

I injured my lower back playing soccer/football one week ago. This is unlike me as I usually do not have injuries and it was a coincidence baring in mind I have been having mild back pain leading up to this. Initially I was unable to walk until the next day. Doctors at the hospital said it's muscular after physically examining me. Now I am back to walking again without any pain but pain is there when sitting in certain chairs/positions. I don't have any radiating pain down my legs at all.

I have had lots of blood work done recently.

2 weeks ago I also had a chest X-Ray and CT Scan of chest, abdomen and pelvis (this was due to the breathlessness symptoms that now seem to have gone). All tests were clear.

My most recent blood test showed the following:-

Total protein level - 78g/l
Albumin - 51g/l
Calcium - 2.5mmol/l
Corrected Calcium - 2.3mmol/l

Platelets - 190,000
Hematocrit - 0.475 L/L
Hemaglobin - 159 g/l
Red blood cells - 5.6 x10e 12/l
White blood cells - 8.7 x10e 9/l
Iron binding sat. - 29%
Unsat Iron bg capacity - 41.5umol/l

PSA - 0.56

Is there any reason for me to worry about my blood results and having Multiple Myeloma?

This is really scaring me

Thank you
doctor
Answered by Dr. Indranil Ghosh 3 hours later
Brief Answer:
these results not suggestive of myeloma

Detailed Answer:
Hi
Thanks for your query.

Your symptoms seem to have abated over time. The creatinine has also gone down after stopping creatine shakes. Other results are not suggestive of myeloma or any other sinister pathology.

I think you just continue according to your doc and stop worrying about multiple myeloma.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 7 hours later
The thing is my bladder still seems a bit irritated.

Also I'm having weird sensations on different parts of my spine. Towards the upper part of my spine I will get like what I can only describe as a burning type of feeling or a shooting type of feeling that only lasts a couple of seconds and then goes away. It's not painful to the point where it hurts but I can feel it. It does this on different parts of the spine as I get it lower down as well. At random points of the day.

Sometimes I do sleep on maybe 3 pillows, could this be a reason why i get this?

Also my

AST - 25
ALT - 19

I understand that with my platelets being 190000
That makes my APRI 0.693.

Does this indicate something going on with my liver ?

Sorry ignore the question about the liver. I miscalculated. Please answer question about spine
doctor
Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer:
Apri not supposed to be done in you

Detailed Answer:
APRI is for patients with hepatitis c to deduce their risk of cirrhosis. So it is not applicable for you. By the way, your APRI is 0.3, which is normal.

The pain sensation does not fit myeloma or bone metastasis. It is likely due to some postural or muscle problem. Sleeping on three pillows may be one of the reasons.

Bladder irritation will be difficult to explain. If it persists, I would recommend a full urological workup including urine analysis, ultrasound and uroflowmetry.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh 4 hours later
One last thing. Last year my father was diagnosed with prostate cancer at the age of 60.
Because of my current urinary issues I was initially worried about this which I why I asked for a PSA blood test to be done. My PSA is currently 0.56.

On top of this test I mentioned I have also had a CT scan with XXXXXXX of abdomen chest and pelvis.

For the fact that I have lost some pressure in my urination and feel the need to urinate sometimes with only a small amount of urine in my bladder. This past week I have been experiencing stabbing or sharp pains that seems to be coming from my rectum. For this reason I am still worried about prostate cancer but the doctor told my my PSA score was normal.

What are your views on this?
doctor
Answered by Dr. Indranil Ghosh 5 hours later
Brief Answer:
Prostate cancer not a possibility

Detailed Answer:
prostate cancer doesn't develop at this age. The PSA result is normal, as expected. So there is no possibility of prostate cancer.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Indranil Ghosh 17 minutes later
I thank you for all of your time and help. Much appreciated.

At what stage of kidney damage/disease would metabolic acidosis occur? Also if the damage to the kidneys would have to be extensive for this to occur, would the damage of been picked up by the CT scan that I had?

I ask this because my episode of shortness of breath was not diagnosed as it went away but tonight I am not experiencing it again.

I meant to write:-

Tonight I *am experiencing it again.

Also with respitory acidosis, can symptoms appear then go away then reappear ?
doctor
Answered by Dr. Indranil Ghosh 11 hours later
Brief Answer:
unlikely to be metabolic acidosis

Detailed Answer:
Metabolic or respiratory acidosis will not clear on its own unless the cause itself is treated. As the symptoms of shortness of breath are transient, you need to look at causes like asthma/allergy.

And metabolic acidosis occurs in late stage kidney disease, say creatinine above 4 mg/dl.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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