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What Do These Following Lab Reports Indicate?
Question: Sore throat, earache bilaterally, nonproductive cough and general malaise x one week. Chronically, with some backache for the past year which has not been relieved by OTC meds. Has had a 15 lb. weight loss of the last year which is unexplained. A history of asthma (treated with inhalers) and arthritis. Dad was hypertensive and died of cancer, site or origin unknown.
Exam today revealed the following:
T-104.2, P-124, regular, R-23 and regular Wt.-151# and Ht.-5’7”
Skin-some pallor noted
EENT-negative other than a few slightly tender A.C. nodes bilaterally
Lungs-breath sounds diminished throughout. Occasionally inspiratory wheezing in
upper airways
Heart-negative Abdomen-negative other than a few nontender inguinal nodes.
Negative X-Ray for pneumonia.
Labs as follows:
Hbg-8.9 WBC-11.6 RBC-2.64 MCV-93.7 Mch-33.5
MCHC-35.8 RDW-15.2 Platelets-189 Neutrophils-65 Bands-11
Lymphs-20 Metamyelocytes-5 myelocytes-4 Monocytes-3
Eosinophils-1
RBC morphology-1+ anisocytosis, basophilic stippling, occasional plasmacytoid
Lymphocyte
WBC morphology-few atypical lymphocytes
CMP: All WNL except Total protein-13.0, Albumin-2.5, Bun 51, Creatinine-2.6
Sed rate was 94.
Urine + for Bence-Jones Proteins
A. What differential diagnoses are you considering and why? (no > 5)
B. What other labs/diagnostic studies are worth pursuing and why?
Exam today revealed the following:
T-104.2, P-124, regular, R-23 and regular Wt.-151# and Ht.-5’7”
Skin-some pallor noted
EENT-negative other than a few slightly tender A.C. nodes bilaterally
Lungs-breath sounds diminished throughout. Occasionally inspiratory wheezing in
upper airways
Heart-negative Abdomen-negative other than a few nontender inguinal nodes.
Negative X-Ray for pneumonia.
Labs as follows:
Hbg-8.9 WBC-11.6 RBC-2.64 MCV-93.7 Mch-33.5
MCHC-35.8 RDW-15.2 Platelets-189 Neutrophils-65 Bands-11
Lymphs-20 Metamyelocytes-5 myelocytes-4 Monocytes-3
Eosinophils-1
RBC morphology-1+ anisocytosis, basophilic stippling, occasional plasmacytoid
Lymphocyte
WBC morphology-few atypical lymphocytes
CMP: All WNL except Total protein-13.0, Albumin-2.5, Bun 51, Creatinine-2.6
Sed rate was 94.
Urine + for Bence-Jones Proteins
A. What differential diagnoses are you considering and why? (no > 5)
B. What other labs/diagnostic studies are worth pursuing and why?
Brief Answer:
Possible multiple myeloma
Detailed Answer:
thank you for contacting HCM with your health care questions
You have been sick this past week and now you have a fever and elevated sed rate with urine positive for Bence XXXXXXX proteins. The elevation is significant showing that there is something wrong and it needs to addressed. The Bence XXXXXXX Proteins in your urine is a protein the is excreted when there are high amount of protein in you urine sometimes seen in multiple myeloma. This is a disease where the bone marrow plasma cells grow quickly and eat away at the bone. But the Bence XXXXXXX proteins could also be a false positive test just because of the fever.
Your labs show the beginning of renal failure and high protein levels which all point to multiple myeloma. I recommend that you be seen by a hematologist oncologist soon. I would even say you should probably need to be admitted to the hospital because you could be dehydrated.
Other diseases that may manifest like this are Waldenstrom's Macroglobulinemia or amyloidosis both of which will need more testing
In summary I would recommend that you go to your local ER to be seen and possibly admitted to the hospital
I hope I answered your question. Please contact us again if you have any further question
Possible multiple myeloma
Detailed Answer:
thank you for contacting HCM with your health care questions
You have been sick this past week and now you have a fever and elevated sed rate with urine positive for Bence XXXXXXX proteins. The elevation is significant showing that there is something wrong and it needs to addressed. The Bence XXXXXXX Proteins in your urine is a protein the is excreted when there are high amount of protein in you urine sometimes seen in multiple myeloma. This is a disease where the bone marrow plasma cells grow quickly and eat away at the bone. But the Bence XXXXXXX proteins could also be a false positive test just because of the fever.
Your labs show the beginning of renal failure and high protein levels which all point to multiple myeloma. I recommend that you be seen by a hematologist oncologist soon. I would even say you should probably need to be admitted to the hospital because you could be dehydrated.
Other diseases that may manifest like this are Waldenstrom's Macroglobulinemia or amyloidosis both of which will need more testing
In summary I would recommend that you go to your local ER to be seen and possibly admitted to the hospital
I hope I answered your question. Please contact us again if you have any further question
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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