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Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 25, 2014

briskranger132 said:SS-A/Ro (Ro 60) IS ONLY SLIGHTLY POSITIVE

Protein levels were fine, ESR and CRP were normal, though my C3 was slightly low.

Ma'am,

Lab results alone aren't enough to diagnose Sjögren or SLE. You need to meet several different clinical criteria to confirm those specific conditions.

Without other qualifying symptoms, you might potentially receive a diagnosis of Collagenosis in obs., which essentially means we need to watch you closely. We'll monitor how your labs and clinical presentation evolve over time to see if they eventually meet the full criteria for a systemic autoimmune disease.

It’s worth noting that anti SS-A (Ro) can show up in a very small percentage of healthy individuals—based on studies of healthy blood donors—but an anti SS-A (Ro) positive result can also be a precursor to an autoimmune disorder.

We now understand that anti SS-A (Ro) isn't just one single antibody; it consists of Ro52 and anti-Ro60, both of which are linked to distinct clinical patterns and diseases.

Specifically, anti-Ro60 is more closely associated with Sjögren syndrome, SLE, and subacute cutaneous lupus (SCLE).

In plain terms, asymptomatic people who test positive for anti-Ro60 face a higher risk than the general population of eventually developing a full clinical picture, such as Sjögren syndrome.

Regarding the CNS lesions detected on the MRI, there isn't much conclusive information to offer.

rapidtinker2 said:I'm heading in for gallbladder surgery and just got my coagulation panel back:

FIBRINOGEN 5.2 (1.8-3.5)
PROTHROMBIN TIME (PT) 18.8 (14.0 - 21.0)
aPTT (ratio) 1.05 (0.80 - 1.20)

I'm wondering if the elevated fibrinogen could pose a problem for the surgery? Thanks!

You should try posting this under Anesthesia/Resuscitation/ICU.

Hannah Nguyen3 said:Can someone please tell me what this urine culture means: bacteria count 10/3, saprophytic cocci, mixed urethral or skin flora. I'm pregnant and can't get to my doctor until Monday.

Ma'am,

this suggests the sample wasn't collected properly for analysis. Either you didn't catch the "midstream" flow and instead caught the initial stream—which carries the bacteria normally found at the end of the urethra—or the midstream sample touched the skin and picked up normal surface bacteria. Or perhaps it was a combination of both.

Greetings. 🙂

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 25, 2014

Jerry Smith4 said:Hello,

Could you please help me interpret these labs? My seven-month-old son’s blood work has looked like this for about 15 days now (we've been testing every three days). Sometimes values are slightly better, sometimes worse—I'm referring to the numbers outside the normal range. Generally, he gets exhausted and falls asleep after very little activity. The doctors at the hospital suspected mono, but the serology came back negative. Now they say it’s some kind of virus, though they aren't sure which one. Our minds are racing with all sorts of possibilities, so I would appreciate any quick insight or opinion:

Hello,

Looking at your child's results, the primary finding is neutropenia—a decrease in the neutrophil count. These cells are essentially the body's first line of defense against infections, particularly bacterial ones.

Based on the report, the neutrophil count is hovering just above 1,000/mm3. While this is lower than the standard for his age, it is still sufficient enough to provide some level of protection.

One of the most common reasons for such a drop in an infant is indeed an infection (though certainly not the only one). Certain viruses have a tendency to temporarily suppress bone marrow function. Among these, EBV is a major culprit behind infectious mononucleosis, but there are many others, such as CMV (which can also present as mono syndrome) or adenoviruses, which can create a very complex clinical picture by mimicking bacterial infections (for instance, causing ear infections)...

I assume the physicians considered these possibilities and ran the serology tests accordingly.

However, if the neutrophil count doesn't return to the normal range, other causes should be considered. You can find more information regarding that on this thread.

Best regards. 🙂

Chloe Ruiz2 said:Thank you so much for the thorough response and clarification! Regarding dyslipidemia, one internist suggested starting atorvastatin, while another felt that red fermented rice supplements (OTC options) would be perfectly sufficient for my case. I decided to follow the second doctor's advice. Best regards, and thank you again for the explanation!

My approach would be to calculate your cardiovascular risk first. If that risk is acceptable, I would start with lifestyle modifications—specifically dietary changes—and then recheck the lipid panel after three months. Unless the risk is high, I wouldn't jump straight to medications like statins.

Best regards. 🙂

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 18, 2014

mellowviper24 said:Thanks so much for the reply.
Regarding glucose—I wasn't fasting, so I'll definitely be repeating that test.

Make sure you redo the glucose test while fasting.

As for the urine, I did a culture after this result came back, but it was sterile. My doctor thinks the urinalysis isn't a concern, but those red blood cells and white blood cells in the urine have me worried. Should I go ahead and repeat the urinalysis?
If the results stay the same, what’s my next move? Should I get an abdominal or kidney ultrasound?
Does the low MCV and iron being at the bottom end of the range have anything to do with the urine findings?

Thanks in advance for your help. 🙂

The relatively high number of squamous epithelial cells suggests the sample might not have been clean. It likely wasn't a midstream catch, or perhaps the sample was contaminated by vaginal secretions or skin contact. This would explain why you aren't showing signs of a UTI and why the culture came back sterile.

Personally, I prefer to re-test anything that sits on the borderline, so I'd do the same in your situation. Just be careful with hygiene when collecting the sample—aim for that first morning midstream catch.

I don't think the MCV and iron levels are linked to the urine results.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 18, 2014

Chloe Ruiz2 said:Hi there!

I’m looking for someone with a bit of insight to help me make sense of some lab results. I’m a woman in my early thirties:

slightly elevated FIBRINOGEN 4.2 g/L (ref range 1.8-3.5)
moderately low MPV 6.2 fL (ref range 6.8-10.4) — platelet count is normal

I also have hyperlipidemia.

Total cholesterol 7.4 mmol/L ( HDL 1.78 mmol/L (>1.2)
LDL 5.4 mmol/L ( Triglycerides are normal.

These tests were part of a checkup because I’ve started hormone replacement therapy due to low estradiol levels (secondary amenorrhea).

I’ve done a little Googling, but I can't quite "connect the dots" into one cohesive diagnosis. Thanks in advance to anyone willing to share their expertise.

Hello,

I don't think you need to look for a direct link between your fibrinogen and cholesterol levels.

In my view, a fibrinogen level up to 5 g/L isn't worth much concern in an otherwise healthy adult. It’s entirely possible this is just your baseline, and it isn't actually "elevated" for you personally. If anything, I’d just retest it in a while to track the trend.

When considering hormone replacement therapy, fibrinogen is a factor to keep in mind when assessing overall thromboembolism risk, but fibrinogen alone doesn't tell the whole story.

As for the MPV, a slightly lower value just means your platelets are a bit smaller than average. Given that your actual platelet count is normal, I don't think it means anything significant.

The cholesterol, however, is a different matter. You should definitely touch base with your primary care physician to calculate your total cardiovascular risk. Discuss a plan with them, then retest in three months to monitor the trend. Based on those follow-up numbers, they can decide if medical intervention is necessary.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 18, 2014

Hey there, your post has been moved to the INFO DESK thread because: a) an MRI isn't a lab result, and b) you aren't asking for a lab interpretation, but rather inquiring about your right to a second opinion. Thanks for understanding.

Lisa Garcia8, I've moved your post to the correct section—Pain under the rib cage.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 18, 2014

crimsonpuma10 said:I thought I’d jump in briefly. I just got my serology results back. I’ve been having some issues with my eyes, and they suspect it might be linked to something systemic or an underlying illness. I’m in my thirties.

result reference range
EBV VCA IgM - NEGATIVE
EBV VCA IgG - POSITIVE >170 pos>=20 neg<20
EBV EA IgG - POSITIVE 57 pos>=20 neg<20
EBNA IgG - POSITIVE >200 pos>=20 neg<20
HSV IgM - POSITIVE
HSV 1 IgG - POSITIVE
VZV IgM - NEGATIVE
VZV IgG - POSITIVE >2000 pos>100 neg<50
VZV IgA - NEGATIVE

Someone, please—if you actually know what this means—could you explain? I am completely lost here. 🙂

Ma'am,

Without more specific medical history, interpreting these serological markers is difficult.

In short, you were screened for three viruses: Epstein-Barr (EBV), which is typically associated with infectious mononucleosis; Herpes Simplex Virus (HSV), usually linked to skin and mucosal infections presenting as blister-like rashes or sores; and Varicella-Zoster Virus (VZV), the cause of chickenpox and shingles.

The results don't suggest an acute (fresh) EBV infection, so your current symptoms probably aren't tied to that particular virus.

Regarding the VZV, you only tested positive for IgG antibodies. This simply indicates you’ve encountered the virus at some point in your life and have developed immunity. Beyond that, clinical history is required to say anything meaningful.

The HSV serology is the trickiest to read. It could also indicate a past encounter with the virus. However, the key factor is whether this was a primary infection or a reactivation of a previous one (noting that over 80% of people over age four have already been exposed).

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 18, 2014

mellowviper24 said:A week ago, I dealt with a stomach flu and intestinal virus, and I've only just recovered today. I had blood work done today, and these are the results:

Hello,

The results indicate:

a) neutrophilia—an elevated neutrophil count. Essentially, at the time of the draw, the high white blood cell count was driven by neutrophils. There are many reasons for an uptick in neutrophils and total white cells, and infections (primarily bacterial) are one common culprit. Regarding the link between asthma and leukocytosis: sometimes asthmatics show elevated white cell counts, but usually, that's due to increased eosinophils. Using an inhaled corticosteroid shouldn't significantly alter a blood count. Given that you've noted elevated white cell counts in several different tests, we really should look at the differential to see which specific cells are driving the total increase. In this case, it's the neutrophils;

b) elevated blood glucose—it's important to confirm if you were fasting;

c) abnormal urinalysis—there's evidence of erythrocytes, leukocytes, and protein in the urine. It would be worth clarifying if there are any urinary tract infection symptoms, vaginal discharge, or gynecological issues... A high number of squamous epithelial cells might suggest the sample wasn't collected properly.

d) low MCV—the red blood cell volume is down, and iron levels are also at the bottom edge of the range. Sometimes a drop in red cell volume serves as an early indicator of iron deficiency. Ferritin is generally a more reliable marker of iron stores than iron concentration alone, as the latter can fluctuate quite a bit throughout the day.

Info Desk [Paperwork, ordering, wait times, procedures, booklets, prescriptions...] in Health · Jan 18, 2014

driftingpilot8 said:Regards,

Has anyone ever filed a complaint about an MRI report or requested a re-read?
I’m talking about an MRI of the brain and cervical spine performed at Medikol.
Over the last few years, I’ve had this scan done three times, so there's plenty of data for comparison. This time, the results were supposedly ready immediately after the scan—which is odd, considering waiting a week for reports at Medikol used to be the standard.
The actual findings consist of just a few brief sentences stating "no significant changes," even though the whole point of the MRI was to track those very "minor" shifts.
So, two issues: 1) the report was issued immediately, and 2) it’s incredibly vague.

What are my rights in a situation like this?

This post was moved from the "Lab Results" thread.

Support resources for families dealing with cancer and other serious illnesses in Health · Jan 12, 2014

Moderator Notice

Our apologies to hollowridge88 for the mistakenly issued red card; it will be rescinded shortly.

The penalty was intended for the post immediately preceding yours. It was triggered by a violation of our PDF guidelines regarding discussions on alternative medical treatments—topics that are strictly prohibited here, as we have a dedicated PDF specifically for Alternative Treatments.

Sorry for the inconvenience.

All entries pertaining to alternative treatment methods have been removed.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 12, 2014

Lou, I've moved your post to the Knee injury thread.

Doxycycline usage/side effects? in Health · Jan 12, 2014

In principle, I’d agree with my colleague, though I would suggest that you should see a urologist given the lack of diagnostic clarity here.

The real issue, however, is the matter of wait times. When will you actually land an appointment, and by then, won't the infection have cleared on its own?

Furthermore, it is somewhat unusual that the symptoms began to subside even before starting antibiotics.

Epididymitis in adults is most commonly bacterial—non-infectious or viral cases are quite rare in grown men. In otherwise healthy American men under 35, Chlamydia is the most frequent culprit, though it isn't a certainty. This is why selecting an antibiotic makes sense, but only if the diagnosis is confirmed.

Additionally, there is the question of whether your partner needs testing (a gynecological exam, swabs) and subsequent treatment.

The antibiotic course should be completed in full, and the effectiveness of the treatment should be verified through microbiological testing.

Doxycycline usage/side effects? in Health · Jan 11, 2014

Jeremy Phillips94 said:I headed to the ER last night because my epididymis was swollen and painful. The doctor there told me to rest, wear loose clothing on my lower half, and prescribed this antibiotic twice a day for ten days. 🙂

He mentioned I should follow up with my primary physician if things don't improve.

Sir,

Treating epididymitis shouldn't be guesswork. It needs to be targeted. That means looking at microbiology results—semen analysis, urine culture, or a urethral swab—and then adjusting the medication based on what those tests actually show.

Generally speaking, there are two main groups of pathogens here, and they require different antibiotics.

On one hand, you have Chlamydia, which is a far more frequent culprit for epididymitis than Mycoplasma or Ureaplasma; doxycycline works well for that. On the other hand, you might be dealing with enterobacteria, like E. coli, which are common causes of UTIs. In that case, a different class of antibiotics is needed.

Did they at least run a urinalysis or a dipstick test while you were at the ER?

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 11, 2014

Eric Hernandez46 said:I went in for a checkup today after finishing my last dose of Klaricid last night. They drew blood this morning and only checked my CRP. It dropped from 32 down to 4.7 (normal range is 0-4), so they told me that's basically it—the inflammation is resolved and should settle down now...

My left leg feels fine now; the tingling has stopped. I’m still feeling a tiny bit of sensation in the right leg, but it's not even 10% of what it was before...

They haven't scheduled my emng yet. I'm not sure if the doctor decided to skip it because the CRP dropped so sharply.🤷

To whom it may concern,

I assume the neurologist prescribed a broad-spectrum antibiotic empirically, as your inquiries don't suggest you were experiencing symptoms typical of an infection.

The significant difference in reflex levels between your upper and lower body, combined with the intense tingling you described in previous posts—which prompted your ER visit—should, in my view, warrant a neurological evaluation.

It might be worth seeking a second opinion from another neurologist.

Karen Hernandez said:Hey. What does it mean if my white blood cell count is normal but my CRP is elevated (around 25)?
By the way, everything else in the CBC looks normal.

First, Paul Johnson, please let us know why those tests were ordered, whether you were experiencing any symptoms, and how many days after the onset of those symptoms the tests were performed.

In principle, CRP is a more sensitive marker than white blood cell counts, so it can sometimes rise due to inflammation or infection while the white cells remain within the normal range.

Doxycycline usage/side effects? in Health · Jan 11, 2014

Jeremy Phillips94 said:Diagnosis: Bartholin's gland inflammation.
Treatment plan: Doxycycline, 100mg twice daily. Minimum duration: 10 days.

So, here’s the question: since I’ve already seen what this specific treatment is used for, is it actually the right move for me?🤔 Mostly used for treating STIs, syphilis, tick bites, malaria... None of which I actually have. 😁

I wouldn't have even thought to look into any of this if I hadn't felt that slight bout of dizziness. Though, honestly, I'm chalking that up to other factors—poor sleep, taking a pill on an empty stomach, and just general exhaustion from being sick. 🙂)

To whom it may concern,

You didn't mention if a urologist actually made this diagnosis, or if you’ve even gone in for any testing yet.

Sure, a full medical history—especially sexual history—would be vital here. But honestly, I think those kinds of questions would cross a line and get way too personal for a public forum like this.

Regarding doxycycline and epididymitis: the logic behind prescribing it is straightforward. For sexually active men under 35, Chlamydia trachomatis is one of the most frequent culprits—N. gonorrhoeae is far less common in that demographic—and this specific antibiotic handles it effectively.

Neck pain help needed in Health · Jan 10, 2014

Dear slish, there's really no need to ask again. There is an entire dedicated thread covering this exact issue located here.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 9, 2014

Eric Hernandez46 said:Thanks for getting back to me. And yes, I went to see a neurologist—seemed like the most logical step.

He prescribed Klaricid 500mg, twice a day for seven days, then follow up. He also wants to run an emng in about ten days. Apparently, we need to wait at least 21 days from when symptoms started to avoid a false negative. That’s how he explained it.

It was a smart move seeing the neurologist.

I'm a bit puzzled by the antibiotic for a respiratory issue, though. If the CRP and white blood cell counts aren't pointing toward a bacterial infection, why the prescription?!

Definitely proceed with the emng, but be prepared for the possibility of needing more tests down the road.

Best regards. 🙂

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 6, 2014

Angela Wright said:It’s exhausting. I can see this just dragging on until they eventually insist on a biopsy.

Unfortunately, if the remaining tests—Dr. Harvey put together a list ranging from metabolic issues to autoimmune liver diseases—don't turn up anything, then yes, a liver biopsy might be recommended.

So, I can at least go out in public, right? I'm not a biohazard? I've run out of excuses to avoid seeing people.

I don't think you're dealing with an acute EBV infection. Given that your viral hepatitis and CMV tests came back negative, there really isn't any reason to isolate or cut off social contact.

Generally speaking, the pattern of results you're seeing is typically interpreted in one of three ways: a past infection, recovery from an infection, or a reactivation. It all depends on your clinical symptoms and the antibody titers.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 6, 2014

Slish, I’ve moved your question to its own thread: Color Doppler (CDFI) of carotid and vertebral arteries - interpreting results. As for Esper, your inquiry has been relocated to Low-grade fever, where you'll find dozens of accounts mirroring exactly what you described.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 6, 2014

Eric Hernandez46 said:Any help is appreciated, thanks in advance 🙂

Hello,

I have to admit, I didn't fully grasp the neurologist's (?) findings. Essentially, if "absent reflexes" are bilateral, it isn't necessarily a pathological sign. As for the reflexes themselves—yes, there is a noticeable difference between the upper and lower body.

What was the actual conclusion from the neurologist? Have you been referred for further testing?

In my opinion, the lab work you've done won't explain why you're experiencing tingling in your feet.

There are minor deviations visible, such as a slightly elevated CRP (an inflammation marker), high uric acid levels (which could relate to weight or diet), and fasting glucose—even though you ate the night before, and your sugar was at the upper limit during your last checkup. It wouldn't be a bad idea to check your HbA1c, and perhaps undergo a fasting glucose test along with a two-hour post-meal test.

Definitely follow up with a neurologist.

Lab results - looking for opinions [PLEASE READ 1ST POST] in Health · Jan 6, 2014

Angela Wright said:Hey guys, I just got my serology results back for CMV and EBV. Most things came back negative, except for Anti-EBV VCA/EA IgG and
Anti-EBV EBNA IgG. Does this mean that along with my gallbladder issues, I also have mono? What does this actually mean, especially since all my tests were fine back in July before that episode? Just to clarify, my blood work is normal aside from the liver panel, and I don't have those typical symptoms. Should I have the baby and my older little one tested too? I'm honestly panicking about them—I felt physically sick just thinking about it (both kids were premature).
It doesn't matter, I've already scheduled an appointment with my internist. Is there any need to see a hepatologist?

Angela Wright,

If I'm reading this correctly, your serological profile looks like this:

anti-EBV VCA IgG POSITIVE
anti-EBV EA IgG POSITIVE
anti-EBV EBNA IgG POSITIVE

(Note that for every parameter—VCA, EA, and EBNA—it specifies IgG only)?

Results like these don't point to an acute infection with that virus.

The reality is that up to 90% of the adult population carries these antibodies. Similarly, about 90% of infections in infancy and early childhood pass without anyone noticing. Generally, the later you contract it—once the immune system is more mature—the more pronounced the clinical symptoms become. Also, people who have had mono can occasionally shed the virus through saliva, so even if someone cleared it a long time ago, they could still potentially pass it to someone nearby.

Double-check your lab report: it would be helpful to write out everything, including the titers if they are listed.

That said, I suspect (though I won't say with absolute certainty) that this virus isn't what's driving your elevated liver enzymes. It's true that EBV infections sometimes present solely through liver changes (without other symptoms), but for everything to persist this long without any shift in your transaminase levels would be unusual.

Admittedly, this specific combination of EBV serology is the trickiest to interpret because of that positive EA, leading to some conflicting info in medical literature regarding what this exact mix signifies. However, it does not indicate an acute infection.