Lab results - looking for opinions [PLEASE READ 1ST POST]

Maria Fisher46 said:Look,

this one is actually a bit more complicated. See, the whole point of testing Anna was to confirm or rule out autoimmune hepatitis. You can see mononuclear infiltration in the portal areas with autoimmune hepatitis—especially if it’s a lymphoplasmacytic infiltrate. Even a titer lower than 1:100 could be significant here, even though you usually see 1:160 or higher. Depending on what your doctor thinks, they can always ask the lab to re-run the test even at such low levels.

Hey Felix the Cat,

Sorry to bug you again. I just had a second liver biopsy done, so I was hoping you could weigh in.

The tissue cylinder is 1.7 cm long with up to 17 portal fields per section. The histological architecture looks normal. There are a few lymphocytes found in some of the portal areas. No piecemeal necrosis or confluent bridging necrosis. Prussian blue staining showed no hemosiderin. No fat accumulation in the hepatocytes either.

Tissue sample length 0.8 cm, dry tissue copper level is 128.6 ug/g s.t.
(<50 is normal, >90 is pathological, >250 is Wilson's Disease).

My doctor is insisting everything is fine—claims the pain is coming from somewhere else and not my liver. They want to repeat the autoimmune antibody tests, ceruloplasmin, blood copper and iron, plus an endoscopy and colonoscopy.

Honestly, I'm losing my mind over all this. Everything feels like it's getting worse, and the mental toll is just brutal.

Can someone tell me if this is a referral for blood or urine?
Thanks.

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steeleagle152 said:Can anyone tell me if this order is for blood or urine?
Thanks.

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It's for blood. I had mine done over at Mount Sinai.

Thanks.

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Can anyone here make sense of these blood work results? I had them done to check on some allergies and to see where my vitamin and mineral levels stand.

B-HEMOGLOBIN: 16.0 (13.4-17.0)
B-LEUKOCYTES: 12.4 (3.5-10.0)
B-PLATELETS: 277 (145-390)
P-IRON 11 (9-34)
P-FERRITIN 99 (30-400)
P-SODIUM 145 (137-145)
P-POTASSIUM 4.4 (3.6-4.6)
P-CALCIUM 2.47 (2.15-2.51)
P-MAGNESIUM 0.95 (0.71-0.94)
P-CREATININE 73 (60-105)
P-AST 35 (15-45)
P-ALT 67 (10-70)
P-AMYLASE, pancreas 18 (10-65)
P-GGT: 55 (10-80)

P-TRIGLYCERIDES: 1.85 (0.45-2.60)
P-CHOLESTEROL 5.0 (2.9-6.1)
P-HDL CHOLESTEROL: 1.3 (0.8-2.1)
P-LDL CHOLESTEROL: 3.2 (1.3-4.3)

P? VITAMIN D: (25-(OH) - CALCIEDIOL): 66 (50-150)
P-VITAMIN B12: (COBALAMIN, TOTAL): 443 (140-600)
P-VITAMIN B9 (FOLIC ACID): 14 (7-40)
P-TSH: 2.0 (0.27-4.20)

ALLERGIES:
P-T4, FREE: 23 (12.0-22.0)
S-IGE, TOTAL: 126 (0-114)
P-IGE SEASONAL ALLERGENS (G6, M2, M6, T3, W6): <0,10 pollen allergy not indicated
S-IGE YEAR-ROUND ALLERGENS: <0,10 no allergy to dogs or cats
S-IGE HOUSE DUST: <0,10
S-IGE ANTI-ASPERGILL: <0,10 molds
S-IGE ALTERNARIA ALTERNATA: <0,10 fungi
ALT3: <0,10
ALG6: <0,10
ALW6: <0,10

Opinion.
Bloodwork is fine
Metabolism is within normal limits
Follow up in 6 months

If I were you, I’d watch my sodium intake and maybe grab an antihistamine if that allergy is really starting to kick your ass.

So, white blood cell counts... is it just me, or does everyone’s body go absolutely haywire once spring hits?

Larry Scott43 said:White blood cell count? Is this just seasonal allergies?

It's just a virus.

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Honestly, I’d probably head to an eye doctor if I were you—just to figure out why you missed the absolute gold standard thread that’s been around forever (we’re talking decades here):

Here’s my lab work (it's pretty old now, from about two years ago)

Sample type: peripheral blood
(Doctors were looking into autoimmune stuff—RA, Sjögren's, SAPHO, maybe MS)

HLA-A
2 10

HLA-B
15 ND

Method: CDC (serological)

__________________________

HLA-C*
NT NT

HLA-DRB1*
04 11

HLA-DQB1*
NT NT

Method: PCR-SSO/SSP (molecular)

My symptoms eased up, so I just gave up on everything. I was just spinning my wheels between the results and the doctors.
Now, though, I'm starting to link my symptoms back to SAPHO syndrome—which the rheumatologist suspected—so I started digging online. Found this:

Some doctors believe that SAPHO syndrome is caused by the same autoimmune processes that cause ulcerative colitis, a severe inflammatory disease of the bowel. There is a specific blood marker for SAPHO syndrome called HLA-B27, which appears in the bloodstream in people who get SAPHO syndrome, ulcerative colitis, ankylosing spondylitis, and another condition that causes problems in both the skin and joints, psoriatic arthritis.

The HLA-B27 isn't mentioned in my results. Does that mean they didn't test for it, or they just didn't find it? I'm completely lost here.

Thanks in advance!

Maria Fisher46 said:Look, when you take everything into account—starting with how long these swollen lymph nodes have been hanging around (definitely more than a month!), their actual size (over 2 cm!), and the fact that all those blood tests so far haven't actually given us a final diagnosis or even a reason why they’re enlarged in the first place—this kid is basically a prime candidate for a needle biopsy, or maybe even a full surgical biopsy where they just take the whole node out for a pathology analysis. It’s pretty obvious too, considering the CBC and differential results haven't stayed normal for a single second during this entire stretch; there’s always something off. Without getting a sample from those nodes and running an actual analysis, there's no way to know what's driving this enlargement. Sure, you see atypical lymphocytes during viral infections, and normally you'd expect them to vanish once the body recovers, but if the infection isn't clearing up or turns chronic, those cells just stick around. That said, you have to remember that atypical lymphocytes can show up for reasons totally unrelated to a virus, which is exactly why this kid needs more follow-up work done.

Good luck.

Hey everyone, the biopsy results came back saying:
'Highly cellular aspirate - shows a large number of lymphatic cells in various stages of transformation, macrophages, lymphoglandular bodies, peripheral blood.'
The nodes are still just as swollen as before.
We don't have any new blood work yet because they don't want to run a pathology test.
There's a follow-up in two months, and they might do another puncture then.
Is this kind of approach even standard or okay? And does this result sound alright—does it just point toward reactive hyperplasia (but on what exactly?!)?

Melissa Phillips4 said:Has anyone else dealt with a situation where a urine culture from the CDC shows something completely different than a private lab?
The CDC results have shown Proteus three times now—and Klebsiella for the first time.
Meanwhile, the private lab says the culture is sterile.
My standard urinalysis has been normal all three times.
I don't have any symptoms—never have.
Is it actually possible for a government lab to make such a massive mistake three times in a row regarding a urine culture? Thanks.

It is entirely possible to have bacteria—one or two types at once—present in the urinary tract without an actual inflammatory response; consequently, you would have no symptoms of an infection.
Therefore, that "normal" urinalysis could be more or less accurate depending on the context.

Lab errors can happen, certainly—but under these specific circumstances, they are impossible to prove.
On the other hand, you aren't showing signs of a UTI, you have no symptoms, and your sediment analysis is clear. What was the reason for running the culture in the first place? An elective gynecological procedure? 🤔

Emily Ortiz27 said:Dear all, my biopsy results show:
'Abundant cellular aspirate—presence of numerous lymphatic cells in various stages of transformation, macrophages, lymphoglandular bodies, peripheral blood.'
The nodes remain equally enlarged.
We don't have new blood work yet—they aren't interested in doing a PHD test.
Follow-up is in two months, with the possibility of another biopsy then.
Is this approach standard and appropriate? Does this finding suggest just reactive hyperplasia (but from what?!)?

Our colleague The Cat (😉) has already pointed out that a full lymph node biopsy is necessary—cytological aspiration often fails to provide an adequate sample for analysis and frequently ends up being inconclusive. That should be the course of action, especially considering the cluster of enlarged mesenteric lymph nodes.

Sandra Vaughn50 said:The colleague, The Cat (😉), already pointed out that a lymph node biopsy is necessary because a fine-needle aspiration usually fails to provide an adequate sample for analysis and ends up being inconclusive most of the time. That’s what really needs to happen, especially given those enlarged mesenteric lymph nodes clumped together.

Thanks so much.

Things have calmed down quite a bit regarding the fever spikes.
On a recent follow-up ultrasound, a different doctor didn't see anything going on in the abdomen, just a bunch of enlarged nodes in the neck.

The hematologist managing my kid refuses to do a biopsy; they just want to repeat the ultrasound and the puncture in two months, and honestly, we don't have any choice but to follow those orders since we don't have the option to just go see another doctor.

From everything I'm hearing from other sources, we really should be getting a plasma protein test done, and looking at the results—since there isn't a descriptive report—it seems like they haven't even performed a blood smear either. I think we can probably get both of those handled privately at some local clinics.

The kid hasn't had those temperature spikes for now, though the night sweats are still hanging around.
Appetite is good, and his general condition is okay (except for when he suddenly broke out in hives all over his body, which required a corticosteroid injection).

So now we're stuck waiting for that check-up in two months and/or just praying those nodes spontaneously shrink back down.

I know I've started a whole thread just for simple questions and answers, but hey, I have to vent somewhere when the doctors "over there" won't actually listen to us. Thanks.

Emily Ortiz27 said:Thank you so much.

Things have stabilized quite a bit—specifically regarding those fever spikes.
During a recent follow-up ultrasound, a different doctor didn't see anything unusual in the abdomen—just several enlarged lymph nodes in the neck.

The hematologist overseeing my child isn't pushing for a biopsy right now; instead, they want to repeat the ultrasound and a puncture in two months. Since we don't have any other options, we have to follow this plan—we simply can't just switch doctors on a whim.

From what I've gathered elsewhere, we really should get plasma protein testing done—and looking at the results, it seems like a cytological blood smear hasn't even been performed yet. We could likely handle both of those through private clinics nearby.

The little one isn't running fevers anymore, though the night sweats are still lingering.
Appetite is good, and his general condition is fine—aside from a recent bout of hives all over his body, which required a corticosteroid injection.

So, we are left waiting for that two-month check-up and hoping those nodes might just recede on their own.

I started this thread for some simple questions and answers—it feels necessary when the doctors "over there" aren't truly listening. Thanks.

This is your child, so it’s only logical that you feel worried.

I agree that the diagnostic workup needs more lab tests to be complete.
It would make sense to run protein electrophoresis, immunoelectrophoresis, haptoglobin, beta 2 microglobulin, LDH, and ferritin. I should note that none of these markers are strictly specific for a potential lymphoproliferative disease, but normal results could serve as an indicator of a more benign situation.

Honestly, I'm not sure why the hematologist is avoiding a biopsy—it isn't drastically more invasive than a cytology puncture, especially with peripheral nodes. Plus, it is certainly more useful for reaching a diagnosis.

You always have the option to seek a second opinion—there isn't just one hematologist in America.
Wishing you the best!

Maria Fisher46 said:It looks like this thread has been getting flooded with questions lately, but there aren't many answers being posted. 👎

If you're running these labs just because you're worried about STIs, I've got some bad news: these results won't rule anything out. You need specific testing for whatever you're actually concerned about (like HIV or syphilis). Your CBC, metabolic panel, and urinalysis can all look perfectly normal even if someone is dealing with an infection.

HIV, hepatitis, and syphilis tests all came back negative. I'm mostly wondering about these elevated numbers in the second photo—specifically the white and red blood cell counts.

Sandra Vaughn50 said:Look, at the end of the day, we're talking about your kid here, right? It’s only natural that you’re feeling stressed out and worried sick. I mean, who wouldn't be?

I mean, I totally agree—you can't just stop there; you really need to beef up the whole process with some actual lab work and blood tests if you want the full picture.
Would it actually make sense to run a full protein electrophoresis and immunoelectrophoresis, along with checking haptoglobin, beta 2 microglobulin, LDH, and ferritin? I mean, look, none of these markers are some silver bullet specifically for spotting a lymphoproliferative disease, but if everything comes back totally normal, wouldn't that be a decent little indicator that we're looking at a more benign situation?

Honestly, I have no clue why my hematologist is acting so skittish about doing a biopsy. Like, seriously, is it really that much more invasive than a simple needle aspiration, especially when we're just talking about peripheral nodes? It’s not like we're performing open-heart surgery here. And let's be real—isn't a biopsy way more useful for actually getting a solid diagnosis anyway? Why dodge the most effective tool in the kit?

Look, you’re always gonna have the option to go out and hunt down a second opinion. It’s not like there’s only one single hematologist working in the entire US, right?
All the best to you!

We went ahead and ran the lab work we were actually able to get done over here, and honestly, for the most part, everything looks pretty decent.
So, my eosinophil levels are sitting at 7.7, when they really should be somewhere between 0 and 6, so they're a little bit elevated. On top of that, my ferritin is looking pretty low at 13, even though the reference range is supposed to be 28 to 365. Just one thing after another, right?
So, I just got my latest lab results back, and honestly? Everything looks solid. My CBC is totally fine—hemoglobin, hematocrit, MCV, MCH, MCHC—all checking out right where they should be. Even the LD, CRP, serum albumin, and total protein levels are all sitting perfectly within the normal range. It’s one of those rare moments where the numbers actually make sense, you know? Just a little bit of peace in the middle of all this chaos.

Hey everyone, could someone help me make sense of these ANA test results?
L93,
CIC Precipitation 0.113 075nm
ANA SS-A (Igg)(ELISA) 164.1 (20 RU/ml)
ANA SS-B (Igg)(ELISA) 3.2 (20 RU/ml)
ANA Sm (Igg)(ELISA) 2.7 (20 RU/ml)
Antithetical nuclear antigens ENA-cut OFF(ELISA)+++

Comment: The antibodies for extractable nuclear antigens ENA include: Jo1, Scl 70,
Thanks so much,
I’d really appreciate any advice or insight you guys can throw my way.

Emily Ortiz27 said:We went ahead and ran some of the lab tests we could manage on our end, and for the most part, things look fine.
Eosinophils are a little high at 7.7 (normal range is 0-6), and ferritin is running low at 13 (normal is 28-365)
The rest of the CBC—hemoglobin, hematocrit, MCV, MCH, MCHC, LDH, CRP, serum albumin, total protein—it’s all sitting right where it should be within the normal range.

Alright, now I can actually get into the weeds here, so I'd love to hear what you guys think. We're still waiting on the protein electrophoresis results, and there were a few other tests they recommended that we just weren't able to get done yet.

Emily Ortiz27 said:Alright, I can finally share the full details now, so please let me know what you guys think. We're still waiting on the protein electrophoresis results, and we haven't been able to get some of the other tests they recommended yet.

I'm attaching the electrophoresis results here.
Can anyone give me some advice? What's your take? Any suggestions on what to do next?