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Posts by placidangler13

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Spent eight days in the hospital. Not like I’m any smarter now, but at least I have some info they tossed my way... (Suspected Fibromyalgia, Sjögren's syndrome M35.0, Polyarthralgia M13.0).
Here’s what I have from my lab results.
Thanks to everyone for all the lab results I've read through so far... and, obviously, thanks for this one in advance. 🙂

So, about Celiac disease—do you actually need a gastroscopy to rule it out for good? I wasn't referred for one, so now I'm stuck wondering what my next move should be.
And then there are these X-ray results from those heavy-duty scans they’ve run a hundred times already... everyone seems to read them differently every single time. 😢 I had them done in Naples, Chicago, and Indianapolis.

Results
EKG: Sinus rhythm, heart rate 75 bpm. Normal electrical axis. Right bundle branch block (RBBB). No ST or T wave changes suggesting ischemia.
Lab results (01/31/2023):
WBC 3.4, RBC 4.54, Hemoglobin 132, Hematocrit 0.399, MCV 87.9, MCH 29.1, MCHC.
Hemoglobin 331 [g/L], RDW-CV 12.7 [%], Platelets 221 [x109/L], MPV 9.8 [fL], Eos 2 [%], Baso 2 [%], Neutro 57 [%].
Lymphocytes 27%, Monocytes 12%, SE 5 [mm/3.6 KS], AST 21 U/L, ALT 18 U/L, ALP 52 U/L, GGT 13 U/L, CK.
ALT 93 [U/L], LDH (s) 167 [U/L], ALP 3.5 [U/L], Glucose (s) 5.0 [mmol/L], Urea (s) 4.4 [mmol/L], Creatinine (s) 71 [umol/L].
URAT 145 [umol/L], T-BIL 7 [umol/L], PROT (s) 74.6 [g/L], ALB 44.4 [g/L], CRP 0.5 [mg/L], ASL-O 295 [U/ml].
Sodium (s) 143 [mmol/L], Potassium (s) 4.1 [mmol/L], Chloride (s) 103 [mmol/L], Iron 14.3 [umol/l], UIBC 53.4 [umol/l], TIBC.
Iron: 16 [ug/l], Transferrin Saturation: 21 [%], Total Cholesterol: 0.69 [mmol/l], HDL: 1.58 [mmol/l], Potassium: 4.30 [mmol/l].
LDL 96 mg/dL, HDL/CO 37%, Appearance (clear), Color (pale yellow), Specific gravity (unspecified)
Specific gravity 1.005, pH 6.0, Nit negative, Prot negative, Glu negative, Ket negative.
Negative for parasites, normal for worms, negative for bile, negative for blood, and 3-5 eosinophils per high power field. Leukocytes present.
(US) 0-1 [Lkc/HPF], Epithelial cells slightly increased [descriptive], Mucus slightly increased [descriptive], Bacteria slightly increased [descriptive], TSH 1.303 [mIU/L], FT3
TSH 4.39 pmol/L, FT4 12.64 pmol/L, Anti-TPO 0.73 kIU/L, IgG 12.10 g/L, IgA 3.07 g/L, IgM 0.80 g/L, C3c.
0.89 g/L, C4 0.24 g/L. No monoclonal proteins detected in the immunofixation. RF 8 IU/ml, total protein 74.6 g/L, A/G ratio 1.49. Protein electrophoresis breakdown: Albumin 44.61 g/L (59.8%), Alpha-1 2.76 g/L (3.7%), Alpha-2 6.86 g/L (9.2%), Beta 8.58 g/L (11.5%), Gamma 11.79 g/L (15.8%). MgB 40 ug/L.

URINE CULTURE (01/31/2023): Sterile
(2/3/2023): Urine tests came back—Ureaplasma: negative; Mycoplasma: negative; Chlamydia: negative.
Negative; Urine - Neisseria: Negative.

Chest and lung X-ray (02/02/2023):
I don't see any signs of fresh inflammatory infiltration or congestive changes in the lungs. The Hilum looks physiologically normal.
Branching. The domes are sharply outlined and very clearly defined. F.C. sinuses are clear. Heart shadow looks normal.
Size and shape.
X-ray, imaging, and hand scans (Feb 2, 2023):
The mineralization of the bone structures shown here looks appropriate. Joint surfaces are congruent, and everything seems normal.
Joint space width. I don't see any obvious morphological changes in the bone structures shown.
Soft tissue structures and patterns. On the ulnar side, there's a visible shadow of a brown ileum.
Right hand.
Standard X-rays of both knees (2/2/2023):
The knee joint surfaces look consistently shaped and congruent, with a normal width.
The joint space looks fine. There's a femoropatellar dislocation with a smooth patellar contour.
FOOT X-RAY (2/2/2023):
Bone structure mineralization and morphology look appropriate. The articular surfaces of the joints shown are
well-formed, with regular and sharp contours and congruent articular bodies, except for both calcanei
where entheopathic changes at the Achilles tendon insertion are visible. No signs of intra- or periarticular
calcification. Soft tissue appearance is within physiological limits.
LUMBAR SPINE X-RAY (2/2/2023):
The bone structures shown have normal morphology. The shape and height of all lumbar vertebral
bodies are normal, maintaining a straight physiological lordosis. The posterior intercorporeal lines are continuous.
Intervertebral spaces in the lumbar segment are of normal width. Small intervertebral joints show normal
morphological appearance. Normal SIJ.
SALIVARY GLAND SCINTIGRAPHY (2/8/2023):
Applied activity: 3 mCi IV.
On the sequential scintigrams taken after radioisotope application, there is symmetrical and normal
activity uptake in both parotid glands and both submandibular salivary glands.
After lemon juice stimulation at the 10-minute mark, there is abundant salivation from all glands.
Conclusion: Scintigraphic function and salivation of all salivary glands are normal.
Status
VOD cc 1.0
VOS cc 1.0
Schirmer II test: right eye 23 mm, left eye 5 mm
AT both eyes: 14/14 mmHg
BM both eyes: eyes calm, no irritation, film is slightly unstable, cornea negative for fl, transparent, AC clear, without
pathological content, Tyndall negative, lenses transparent.
FOU: Clear fundus boundaries, macula is normal, periphery is normal, retina is attached; no
ruptures or hemorrhages noted.

Blood culture: pending.
Results pending: ANF, anti-dsDNA, ENA-screen, CCP, celiac testing, blood culture.
Maria Fisher46 said:Hi there,

Based on these results, it probably isn't systemic lupus erythematosus. However, I don't see anything being done to rule out celiac disease, inflammatory bowel disease, or sarcoidosis—all of which you seem predisposed to based on your HLA typing.

Thanks a lot. I haven't seen the immunologist yet. Heading there next week, so the doctor will probably hand over referrals for more testing then.
Nicholas Myers, thanks for the heads-up earlier. 👍>

I’m not great with links and uploading images, so hopefully this works.
(After those first results, this one just came in... looking for some insight. My doctor suspects some kind of systemic disease... long story short.)

LAB (Oct 21, 2022): CK 93[U/L], LDH (s) 187[U/L], Mg 37[ug/L], PROT (s) 78.7[g/L], CA 19-9 5.6[kIU/L],
CA 15-3 13.6[kIU/L], CA 125 9.0[kIU/L], CEA 0.8[ug/L], AFP 3.7[kIU/L], CA 72-4 1.4[kIU/L], ANF BORDERLINE
, ANF tit 1:100 , ANF flo PATCHY , ds DNA 6[IU/ml], ENA -screen POSITIVE[descriptive], SS-A(60) 1[AU/ml],
SS-A(52) 126[AU/ml], SS-B/La 1[AU/ml], Sm 2[AU/ml], Sm/RNP 0[AU/ml], Jo-1 2[AU/ml], Scl-70 3[AU/ml],
RibosAt 5[AU/ml], CentromAt 1[AU/ml], U1RNP 2[AU/ml], PmSCl 2[AU/ml], PCNA 11[AU/ml], HistoniAt
6[AU/ml], FID-p ANCA 0[AU/ml], FID-c ANCA 1[AU/ml], CCP < 5[CU], IgG 12.10[g/L], IgA 3.40[g/L], IgM
0.88[g/L], No monoclonal proteins found in protein electrophoresis., RF 8[IU/ml], PROT (s) 78.7[g/L], P-EF-ALB%
59.6[%], P-EF-Alf1% 3.7[%], P-EF-Alf2% 9.5[%], P-EF-Beta% 11.6[%], P-EF-Gam% 15.6[%], P-EF-ALB
46.91[g/L], P-EF-Alf1 2.91[g/L], P-EF-Alf2 7.48[g/L], P-EF-Beta 9.13[g/L], P-EF-Gam 12.28[g/L], P-EF-A/G
1.48

LAB (Sept 29, 2022): ASL-O 348[U/ml], IgE 21[IU/ml]
...anyway, here's what I posted last time, just to make the picture clearer.
HLA TYPING (Oct 21, 2022):
Class I / HLA-B B8 B50(21) *08 *50
Class II / HLA-DRB1 DR17(3) - *03 -
Class II / HLA-DQA1 *05 -
Class II / HLA-DQB1 DQ2 - *02 -

And also...
SEROLOGY (Oct 21, 2022): anti-EBV VCA IgG pos., anti-CMV IgG pos.

On top of that, there's the EMG... an immunologist ordered all of this (feels like I won the lottery, if that were a good thing).

EMG findings for legs:
M.tibialis anterior lat.left: slight reduction in innervation pattern with emergence of wider and higher compensatory action
potentials up to 8 mV, repetitive discharges
M.tibialis anterior lat.right; M.extensor digitorum brevis bilateral; M.gastrocnemius caput medialis
bilaterally: shows good to intermediate innervation pattern with emergence of wider and
higher action potentials of compensatory type with amplitude around 8 mV repetitive discharges.
Neurographic analyses - results attached.
CONCLUSION
EMG findings combined with clinical presentation in the legs indicate moderately
severe chronic, well-compensated L4 radiculopathy on the left, plus moderate chronic, well-compensated polytonic L4 radiculopathy on the right, L5
bilateral, and S1 bilateral.
Neurographic analyses showed no signs of polyneuropathy or compressive mononeuropathy in the
tested nerves.
nk

Thanks in advance. 👋
Can anyone help me make sense of these HLA typing results?

It’s some kind of systemic issue... gut, joints, etc. I won't go into all the details, but I'm running every test under the sun and they still don't have an answer. I'd be grateful if someone could help me interpret this:

HLA LOCUS SER. EQUIV. ALLELE ALLELE

Primary sample: whole blood
SER. EQUIV.
Class I / HLA-B B8 B50(21) *08 *50
Class II / HLA-DRB1 DR17(3) - *03 -
Class II / HLA-DQA1 *05 -
Class II / HLA-DQB1 DQ2 - *02 -
Notes:
- = possible homozygosity
Method:
Molecular typing via PCR-SSO using Lifecodes HLA-B kit Lot 3012346, Lifecodes HLA-DRB1 eRES SSO
Typing Kit Lot 3012606 and Lifecodes HLA-DQA1/B1 SSO Typing Kit Lot 3012027. MatchIT DNA IMGT/HLA database 3.45.