Dealing with a bunch of symptoms: rash, sun sensitivity, swollen lymph nodes, headaches, and stomach

I’ll start by attaching a photo of the butterfly rash I had, and then I’ll list all the "issues" I've been dealing with since 2003...

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These blisters popped up after I spent about six hours playing beach volleyball in the sun—it wasn't my first time out, even though I don't play that often, and I'm not usually that sensitive to UV exposure—back in June.
When I ended up in the hospital in July (due to some inflamed lymph nodes), things flared up significantly; it was extremely red and swollen. Once my fever started breaking, it calmed down and returned to its previous state—just some redness, but nothing intense... It seemed to be improving over a couple of weeks, but then suddenly, everything flared up again, and stayed that way until three weeks ago.

To the touch, it felt slightly swollen, and since this had been going on for three months, it was gradually increasing, though not at an extreme speed.

Here is a photo of how it looked when it was relatively okay—you can't see much, but there was still some swelling. I had this on both sides of my face. The left side was milder, while the right side was quite pronounced.



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I finally saw a dermatologist after two months because the symptoms just wouldn't subside.
The test results I received are listed below...

Demodex Foll. came back negative—if I wrote that correctly...
Positive for P. oval (several instances)



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My second dermatology appointment was after I got those last results, and by then, the redness had actually calmed down for about two weeks...
The dermatologist's take was that I have seborrheic dermatitis—a genetic condition (though as far as I know from looking at my family, nobody else has ever dealt with it)—and they prescribed a cream for me to use if it flares up again...

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So, here's the thing...
A few days ago, I was at the beach, went for a swim, and then laid out on a lounge chair and fell asleep. I was out in the sun for maybe half an hour (it was around 4 or 5 PM), and as soon as I woke up, I could feel it coming back... specifically, this sensation on my face that just feels "off."
That area is turning red again, and the blisters have reappeared...

I've actually had a sun allergy since 2002. Specifically, on my hands and the lower part of my legs. Since that first occurrence, the issues have only happened in those areas, and I do spend quite a bit of time in the sun (though obviously, I'm careful about those specific spots).

I wonder if I've developed a sun allergy on my face as well. How would I even check for that? My dermatologist didn't mention that as an option...

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Health issues since 2003:

2003 to present —even though it hasn't been as bad the last four years (since I have a "lighter" physical job now), I've dealt with pain in my right abdomen. Terrible pain, and no one could figure out the cause. I spent two years undergoing tests, and we never found anything. It's better now, appearing only about three times a year, which is a relief... previously, it was almost daily, and despite taking various painkillers, nothing helped. I was screaming and crying, feeling completely helpless. It usually happened most often when I was doing physical labor, lifting heavy objects, or walking a lot, but it would also catch me while I was sleeping and wake me up... there wasn't any logical pattern to it...

2007 —lost 7 pounds in two weeks (for my height, I dropped down to 121 lbs at the time). I attribute that to the stress of my grandmother's illness and passing, among other things... I can't prove it, so I'm just sticking to that theory. I've been struggling with my weight ever since. I managed to get back up to around 132-134 lbs recently (which I'll write more about later)...

May 2011- My headaches started hitting about 3 or 4 times a week... I went through several checkups, and they eventually found a clear spot on my pituitary gland—my endocrinology results were fine—which they want me to monitor, though the specialists don't think it's what's causing the pain. The neurologist I saw was honestly pretty unpleasant—to put it politely—and after a year of putting off more tests, I started taking Tegretol around month 6. Since then, things have stabilized somewhat. The headaches aren't as frequent, and when they do happen, they aren't quite as unbearable as they used to be..

June 2012 - That "butterfly rash" appeared—exactly as I described earlier...

July 2012 - I ended up in the hospital after running a fever for five days straight, coupled with intense light sensitivity and vomiting. My lymph nodes were swollen too—in my neck, under my ear, and under my armpit. The diagnosis was lymphadenitis, which they treated successfully with antibiotics.

From July 2012 until now - those lymph nodes are still there. They're noticeably swollen. The one under my left armpit is still present, and now the one under my ear has flared up again (though the one under my ear subsided for about three weeks). I had an ultrasound where they confirmed the swelling and measured the size. Later, I saw a hematologist who suggested sending me for a biopsy to see what's really going on.
The hematologist actually claimed the swelling under my arm was just connective tissue—after he squeezed it so hard it hurt for the rest of the day—even though the ultrasound clearly showed otherwise. By then, the node under my ear had shrunk enough that he couldn't examine it properly. To make matters worse, some representative from a pharmaceutical company happened to be visiting during the appointment, and I felt like I was practically kicked out of the office within two minutes of this "exam." They basically told me everything was fine and that I should just perform self-exams... I still have this issue today, and I'm at a loss for what to say or do next..

From July until now - since getting sick (maybe even before, I've lost track because everything became so overwhelming), I've lost about 7 or 8 pounds and it just won't come back. I eat "normally"—well, in amounts that might seem excessive—but I tend to eat late, usually after 8 or 9 PM, so I know it isn't a diet issue..

One more thing—over the last few months, I've noticed my hair is thinning quite a bit. Much more than usual. It’s a little scary, though it hasn't reached the point where it's visibly thinning yet..

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I hope I haven't made this too complicated; I tried to keep it brief while including everything I could remember. Who knows, maybe I missed something... I'll try to recall if anything else comes to mind..

What I'm really wondering is, since I feel like I've hit a dead end, if anyone else recognizes these symptoms? I don't really have any other options left but to post here and hope that tomorrow I'll be a bit more "enlightened"..

Thanks for taking the time to read this.

Best, restlessangler

http://emedicine.medscape.com/articl...4-workup#a0756

Take a look at the criteria in that link, then go over your own lab results—if you hit four of those markers, the diagnosis would be Lupus.

First off, there’s that butterfly rash on your face. Second, you've got that photosensitive rash.

Beyond that, you're going to have to do the math yourself since I can't see your actual labs.

During any kind of "flare," you really should be seeing changes in your ESR, C3, C4, and total complement levels.
Lymphadenopathy—you know, swollen lymph nodes—often goes hand-in-hand with Lupus, even if it isn't technically one of the official diagnostic criteria. And headaches? According to the literature, they are common (read: way more frequent than in the general population) with Lupus, though honestly, that's a hard thing to objectively prove—I mean, is there anyone out there who *doesn't* get a headache every once in a while?

The hair loss and weight loss could also be tied to hyperthyroidism—think Graves' disease or maybe Hashimoto's. Both of those are autoimmune conditions just like Lupus, so they frequently show up alongside it.

Kate Collins67 said:http://emedicine.medscape.com/articl...4-workup#a0756

Take a look at the criteria in that link, then compare them to your own lab results—if you meet four of them, the diagnosis would be Lupus.

You have that butterfly rash on your face... and then there's the other rash triggered by sunlight.

Beyond that, you'll have to figure it out yourself since I can't see your labs...

During any "flare," you should ideally have specific markers checked: ESR, C3, C4, and total complement levels.
Swollen lymph nodes often go hand-in-hand with Lupus, even if they aren't part of the official diagnostic criteria. Headaches are also pretty common according to the literature—more so than in the general population—though it’s hard to prove objectively, since I don't think anyone goes through life without getting a headache once in a while...

Hair loss and weight loss could also be tied to hyperthyroidism (like Graves' disease or even Hashimoto's)—both are autoimmune just like Lupus, and they can definitely show up alongside it.

Hi,
first off, thank you so much for responding.

That's actually why I did some research, which came back negative for Lupus. I'm not sure if you can see the photo below my face, but that was for dsDNA. My dermatologist told me—well, she said—that we're ruling out Lupus and that it's just seborrhea.
I've read a bit about seborrhea, but honestly, I can't really see myself in that description... especially since no one in my family has ever dealt with redness issues before.
I haven't read much more, though maybe I should have... I did come across a blog written by a guy talking about this condition.
The causes mentioned are stress (which has been way higher for me over the last four years—actually, more than ever, so logically I should still be red), lack of sleep (which I know I have, but I've never had patches because of it), a greasy diet (which I never pay attention to, so... it's weird I haven't seen spots yet), and deficiencies in Vitamin B, C, zinc, and iron—though my blood work from two months ago looked great.

I thought the same regarding hormonal issues, because I forgot to mention that for the past year and a half, I've been dealing with excessive hair growth in places where I never used to have any. I was told this is normal, but it doesn't feel normal to me when I have to pluck it away. Between the endocrinology results and the pituitary MRI (where they found a cyst), everything went to a consultation where they basically ruled out any actual problems. But I doubt that's true, because the hair growth issue isn't going away. No one can tell me that it's okay for someone like me—with fair skin, light brown hair, and no history of dark hair—to suddenly have this...

I'm hoping more will be clear next year, as I'm scheduled for a follow-up MRI and more endocrinology appointments to monitor the pituitary cyst. Otherwise, I can't really "prove" that I'm definitely not healthy...

To be honest, lately I feel like a hypochondriac, like I'm searching for a disease. But I can see that something is happening that isn't right. No doctor can tell me that having inflamed lymph nodes for three months straight is normal. And don't even get me started on the rest of it. Because of those lymph nodes, I've avoided playing volleyball all summer because I'm terrified something will flare up and I'll have to go on medical leave again. It's no way to live...

Since you're already bringing up the hair growth thing, I was wondering, have you actually had your sex hormones checked yet?

What kind of labels are they using for those? You should probably double-check your lab results... hang on a sec

restlessangler said:Hey,
first off, thank you so much for getting back to me.

That’s actually why I did some digging—everything came back negative for Lupus. I don't know if you can see that picture under my face, but that's for the dsDNA. Later on, my dermatologist—well, she told me—said we're ruling out Lupus and that it's just seborrheic dermatitis.

Sometimes you run into these overlapping conditions where you end up showing symptoms and lab results from one autoimmune disease alongside things from another. It's confusing, right?

You really need to comb through all your labs. If they weren't testing you during those specific flare-ups—you know, when the skin issues, stomach pains, or fevers hit—did they at least check your ESR and C3, C4, and total complement levels? Those are your big indicators for autoimmune activity, along with the usual stuff. Honestly, ESR isn't even a routine test at many clinics anymore because everyone just uses CRP instead, but let's be real: you don't get the same level of detail from both. They aren't interchangeable!

Look, if your results show high ESR combined with low C3 and/or C4 and/or low total complement, then you have strong evidence of an autoimmune issue involving immune complex formation (Lupus being one of them). At that point, you have to be persistent—really push—to figure out exactly which one it is.

Make sure you get your thyroid hormones checked (T3, T4, TSH). If those suggest a thyroid problem, you'll need an ultrasound and tests for Anti-TPO, Anti-Tg, and Anti-TSI—though I'm not entirely sure which local lab handles those specific ones... Looking back, if you were ever seen in endocrinology, they probably already ran most of this (at least the basic thyroid panel).

One thing you definitely should have by now is your CBC. Go through your records and check how many of them show low values for WBC (white blood cells), platelets, lymphocytes, or RBC (red blood cells). Also, check your urinalysis: look at what it says next to protein. If you haven't had one done in a while, go ahead and redo it.

And if you've ever had a biopsy done on any of those skin patches, make sure you get the actual pathology report.

My T3 was at 1.5 in March—the range is 1.1 to 3.1
T4 was 118 (normal is 60–165)
TSH was 0.96 (range 0.4–4.0)

Does anyone know what SE, C3, and C4 tests actually look for?

We were supposed to do a biopsy, but since the rash started clearing up, we decided to hold off...

Are CBC tests considered general blood work?
I don't have my most recent results handy—they're still sitting on my doctor's computer. Besides, there's really no point in uploading the labs from when I was actually sick, since they were all skewed anyway...

restlessangler said:What kind of tests are SE, C3, and C4?

They were supposed to do a biopsy, but since my rash cleared up, we didn't end up doing it.

Is CBC just general blood work?
I don't have my latest results on me—they're still sitting in the doctor's computer. And honestly, there's no point in uploading results from when I was actually sick anyway, since they'd all be skewed...

CBC—that’s your complete blood count: red blood cells, white blood cells, platelets.
SE is erythrocyte sedimentation rate, and C3 and C4 are complement components. (Given how you're asking, I'm guessing they weren't even run.)

The lab results taken during active flares are exactly what will help clear things up the most.
Were you actually admitted to the hospital, or was this all outpatient stuff? If you were hospitalized, you should have discharge papers that list every single test performed along with the actual values.

I’ve got my test results. I’ll try to get everything uploaded later tonight. I actually had to be hospitalized once when my Lupus nodes were flared up—I was running such a high fever... everything else has just been outpatient care.

Dear,

Your inquiry doesn't clarify if you've seen an internist—specifically an immunologist. From what I gather, a dermatologist ruled out a systemic connective tissue disease, but that really should be the call of an immunologist.

The facial changes you described, and those visible in the photo, don't look like classic seborrheic dermatitis. Of course, without a physical exam, it would be reckless of me to claim that definitively. Also, whether someone in your family has had this condition isn't a deciding factor in diagnosing seborrheic dermatitis, so don't rely on that family history to determine what you're dealing with.

The differential diagnosis for red facial lesions is vast. However, in your case, certain systemic signs stand out—everything from swollen lymph nodes to weight loss. It’s logical to ask if there is a systemic disease at play. It could be several unrelated issues, but based on your description, they feel interconnected.

With photosensitive reactions (you mentioned a "sun allergy"), itching is quite common, and typically, it's more intense than the discomfort usually associated with Lupus.

I also want to point out that systemic Lupus (SLE) isn't the only form of the disease. Yes, with modern updates to ANA testing methods, there is a small chance of an SLE diagnosis even if the ANA comes back negative. That said, false negatives happen, and immunology is full of surprises. If there is strong suspicion of SLE, regardless of a negative ANA, it would make sense to run an ENA screen to look for other antibodies, along with the other tests already suggested, like complement levels.

There are specific types of lupus—such as subacute cutaneous lupus, discoid lupus, or lupus erythematosus tumidus—where the ANA might not be positive, yet other antibodies can be detected.

A skin biopsy is a vital piece of the diagnostic puzzle. It would be wise to have a dermatologist with significant experience in this area evaluate whether a biopsy is necessary.

Regarding the lymphadenopathy: you haven't mentioned how large the lymph nodes are or if they've been biopsied/aspirated, nor what those results showed.

Try to track down the records from your hospital stay. There might be more information hidden in those files.

I'm going to list the test results I've had from about a year and a half ago.
Before I get into the actual findings, I should mention why they were ordered in the first place.

Headaches:

EEG 07/18/2011- Recording performed while awake.

The baseline cerebral activity shows an alpha rhythm at a frequency of 10-11 Hz, which is of medium amplitude and blocks well upon eye opening. There is a diffuse interposition of slightly more waves, primarily at a frequency of 6-7 Hz, with occasional tendencies toward bilateral grouping. No significant asymmetries or paroxysmal bursts were recorded. Hyperventilation did not show any changes.
Conclusion/comment: A slightly higher amount of slower waves over all areas of the cerebrum (mild diffuse dysrhythmia)

Brain MRI - 09/12/2011

In the brain MRI using standard imaging techniques, multiplanar sections show normal organization of the cerebral gyri and sulci, along with appropriate gray and white matter ratios.
Brain parenchyma intensities are physiological both infra- and supratentorially. There are no signs of ischemia, intracranial hemorrhage, or tumor processes.
The ventricular system is centrally located and morphologically appropriate.
Near the dorsal part of the adenohypophysis, a cystic formation measuring approximately 6-7 mm is visible—follow-up imaging of the pituitary-hypothalamic region is recommended.
No visible pathological changes in the parasellar region, pontocerebellar angles, or the craniocervical junction.

Ophthalmology Clinic - 10/06/2011

Status: VOD 1.0 sc
VOS 0.7 nk
Biome is normal
Fundus of the eye: PNO clearly delineated, level, blood vessels appropriate for age. Macula is clear
Intraocular pressure: 14.5 mmHg

Blood work - Urea and Creatinine (ordered due to contrast for the pituitary MRI) - 11/28/2011

Urea - 5.0 (range: 2.8-8.3)
Creatinine - 94 (range: 63-107)

Pituitary MRI - 12/09/2011

On the three-plane pituitary MRI, including native T1 and T2 and post-contrast sequences, the pituitary gland is normally positioned with regular shape and size; however, there is a cystic formation measuring 7.7x4.9 mm located posteriorly on the left. The pituitary stalk is medioponated and regular.
The pituitary has a homogeneous and regular structure, with the aforementioned cystic formation noted on the native layers.
Parasellar and suprasellar regions show no changes. The optic chiasm and cavernous sinus appear normal.
Following IV contrast administration, the pituitary enhances homogeneously, except for the described cystic formation, which does not take up contrast.

Endocrinology Lab - 02/08/2012

Day 3 of cycle - f. f.

T3 - 1.5 (range: 1.1-3.1)
T4 - 118 (range: 60-165)
TSH - 0.96 (range: 0.4-4.0)

LH - 8.2 (FF range: 2.4-12.6)
FSH - 8.3 (FF range: 3.5-12.5)
Estradiol - 190 (FF range: 80-790)

Testosterone - 1.4 (range: 0.4-1.7)
Free Testosterone - 9.7 (0.9) - 1-33 (range: 0.7-2.6)
SHBG - 122 (range: 17-125)

Prolactin - 4.5 (range: 2.0-30.0)

02/13/2012

Cortisol - 631, 376, 334, 322, 644, 536 (8 hours: 138-800; 17 hours: 80-488)
HR - 0.26; 0.19; 0.17; 0.54; 3.97; 3.72 (adult range: 0-5.0)

Glucose measurement 1: 5.2 mmol/L
Glucose measurement 2: 3.5 mmol/L
Glucose measurement 3: 2.3 mmol/L
Glucose measurement 4: 1.5 mmol/L
Glucose measurement 5: 3.2 mmol/L
Glucose measurement 6: 3.9 mmol/L

EEG 05/18/2012 - the findings are identical to the first one, literally.

The baseline cerebral activity shows an alpha rhythm at a frequency of 10-11 Hz, which is of medium amplitude and blocks well upon eye opening. There is a diffuse interposition of slightly more waves, primarily at a frequency of 6-7 Hz, with occasional tendencies toward bilateral grouping. No significant asymmetries or paroxysmal bursts were recorded. Hyperventilation did not show any changes.
Conclusion/comment: A slightly higher amount of slower waves over all areas of the cerebrum (mild diffuse dysrhythmia)

That's where I stopped looking for answers... I just got so discouraged with the medical system here. Plus, once I started taking Tegretol, my headaches were "under control," even though we never actually found the cause...

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That part was just about the headaches—I’ll move on to the lymph nodes, ultrasound results, and the hematologist next, just so this stays somewhat organized...

Emergency Medical Record 07/01/2012

Lymph node clusters in neck regions II and III present bilaterally—more pronounced on the left—measuring up to 3 cm; they feel elastic, movable, and tender to the touch, though no fluctuation was noted. Throat exam shows a calm oropharynx, normal epiglottis and endolarynx, and no pathological secretions in the nasal cavity...

07/01/2012 Emergency Visit with F. Mihaljević (1st time)

It’s been six days since the swollen lymph nodes appeared in the neck and armpits (starting June 26th)... they've been gradually increasing in size and are painful to the touch. Had low-grade fevers on June 29th and 30th, but today the fever hit 38.4°C. Feeling chills without shivering, vomited once, feeling exhausted and generally weak, plus a headache for the last two days along with light sensitivity. No sore throat, no nasal discharge, and no cough. Bowel movements and urination are normal. She was previously seen at an ENT clinic at Memorial Hospital—they didn't suggest any surgery. She’s been on Clindamycin for four days now...

Clinical status: BP 110/60, HR 84, RR 16. Patient is conscious, lethargic, but communicative and oriented. Feverish, normal color, mobile, but photophobic. Cardiovascular system is compensated. General condition is moderately severe. Meningeal signs present—neck stiffness occurs during flexion... Skin shows no rashes or bruising. Lymph nodes are about 1.5 cm on the right and 2 cm on the left, moderately tender, located behind the left sternocleidomastoid. Nose is clear. Throat is pink, tonsils were removed, no visible exudate; tongue is moist and clean. Lungs: normal breath sounds. Heart: rhythmic, clear tones, no murmurs. Abdomen is soft, non-tender, no organomegaly, bowel sounds present. Extremities show no edema and pulses are palpable. Neurological: pupils are dilated, equal, and reactive to light; bulbar motor function is normal, no nystagmus, no double vision, no cranial nerve deficits. In AG position there is no lateralization; stable in Romberg; finger-to-nose test shows no dysmetria...

Blood draw:

WBC - 3.8 (3.4-9.7)
NE% - 70.5 (44-72)
LY% - 20.1 (20-46)
MO% - 8.0 (2.0-12.0)
EO% - 0.2 (0.0-7.0)
BA% - 1.2 (0.0-1.0)
NE# - 2.7 (2.1-6.5)
LY# - 0.8 (1.2-3.4)
MO# - 0.3 (0.1-0.8)
EO# - 0.0 (0.0-0.4)
BA# - 0.0 (0.0-0.1)

RBC - 4.27 (3.86-5.08)
HGB - 135 (119-157)
HCT - 0.410 (0.356-0.470)
MCV - 96 (83-97.2)
MCH - 31.5 (27.4-33.9)
MCHC - 329 (320-345)
RDW - 11.7 (9.0-15.0)

PLT - 136 (158-424)
MW - 7.7 (6.8-10.4)

Returning to the ER in 2 days:

Temperature: 39.5°C, BP 90/55, HR 78, RR 16
Conscious and oriented, but running a high fever, sweating, lethargic; general condition is moderately severe. Slight terminal neck stiffness when pain occurs. Kernig negative; feels slightly better in a tripod position. Lymph nodes under the left armpit are enlarged and painful, also enlarged on the left angle, less painful submandibularly on the right, with several smaller ones on the neck. Skin: still showing redness under the eyes. Throat is pink, no exudate; tongue is less moist, less coated. Heart and lungs sound normal upon auscultation, abdomen is soft and non-tender with no organomegaly, bowel sounds present. Lung sounds are clear, neurological exam shows no major deficits...

Day hospital results:

Glucose - 5.4 (4.4-6.4)
Urea - 5.0 (2.8-8.3)
Creatinine - 76 (63-107)
Sodium - 134 (137-146)
Potassium - 3.9 (3.9-5.1)
Chloride - 98 (97-108)
CRP 53.2 (0.0-5.0)
Total Bilirubin - 5.0 (3.0-20.0)
AST - 20 (8-30)
ALT - 20 (10-36)
GGT - 33 (9-35)
LD - 187 (0-241)

Fingerstick glucose - 11.8 (4.4-6.4)

Cerebrospinal fluid

CSF - Total proteins - 0.33 (0.17-0.37)
CSF - Glucose - 3.4 (2.5-4.4)
CSF - Chlorides 118 (ref 115-129)
CSF - Turbidity - clear (clear)
CSF - Xanthochromia - colorless (colorless)
CSF - Blood reaction - 0 (0)

No microorganisms detected...

Urine

Leukocytes - 5-6
Erythrocytes - many
Cells - epithelial cells
Bacteria - bacteria present

PRO - 0.25 (0/neg)
GLU - normal/neg (0/neg)
KET - 15 (0/neg)
UBG - normal
BIL - negative
LEU - 25 (1+)
ERY - 250 (4+)
NIT - negative
SG 1.010
PH - 7

Toxoplasma serology came back negative, and there were some clinically insignificant reactions to Bartonella, EBV, and CMV...

That covers everything from my hospital stay—next up is an ultrasound and seeing the hematologist. I'm also attaching the blood work I have from July and September of 2011...

Breast and bilateral axilla ultrasound - 09/03/2012

Skin and subcutaneous tissue appear normal, with regular glandular parenchyma...

On the left side at the 2 o'clock position, there is a 6.4 mm cyst—plus two more at the 3 o'clock position measuring 6.9 mm and 4.5 mm.
In the right axilla, there is one regular lymph node measuring 9.3 mm.
In the left axilla, there are two lymph nodes with maintained architecture, measuring 9.1 mm and 19 mm, showing increased hilar vascularization.

No other focal lesions or expansive masses were found.

Hematologist 09/10/2012

Back in July 2012, there was some unclear fever and lymphadenopathy, but things have been fine since then.
Currently afebrile; neck, axilla, and inguinal lymph nodes are palpable within physiological limits—the spleen is also palpable.
I suggest the GP check the palpable findings and continue monitoring, potentially with follow-up ultrasound scans...

I'm looking at this urine analysis for Fran Mihaljević—is there really nothing listed here about proteins?

Can you just list out the diagnoses from both of Fran Mihaljević's lab results?

How many days of antibiotics were taken, how long after the fever finally broke, and which antibiotic was it—assuming they actually switched up the treatment? And tell me, you don't have a cat, right?

Bloodwork results

07/01/2011

RBC - 4.07 (3.86-5.08)
Hgb - 133 (119-157)
Hct - 0.396 (0.356-0.470)
MCV - 97.3 (83.0-97.2)
MCH - 32.7 (27.4-33.9)
MCHC - 336 (320-345)
RDW-CV - 12.5 (9.0-15.0)
WBC - 4.7 (3.4-9.7)
Neutrophils - 34.8 (44-72)
Lymphocytes - 52.2 (20-46)
Mid cells (MID) - 13.0 (2-19)

Platelets - 204 (158-424)
PDW - 13.8 (3.8-16.2)
MPV - 9.9 (6.8-10.4)
ESR - 11 (4-24)

Glucose 4.2 (4.2-6.0)

AST - 16 (8-30)
ALT - 10 (10-36)
GGT - 12 (9-35)

Iron - 26.4 (8-30)

09/27/2011

RBC - 4.22 (3.86-5.08)
Hgb - 136 (119-157)
Hct - 0.411 (0.356-0.470)
MCV - 97.4 (83.0-97.2)
MCH - 32.2 (27.4-33.9)
MCHC - 331 (320-345)
RDW-CV - 12.1 (9.0-15.0)
WBC - 5.4 (3.4-9.7)
Neutrophils - 41.8 (44-72)
Lymphocytes - 47.3 (20-46)
Monocytes - 9.2 (2-12)
Eosinophils - 1.5 (0-7)
Basophils - 0.2 (0-1)

Platelets - 202 (158-424)
PDW - 14.0 (3.8-16.2)
MPV - 10.3 (6.8-10.4)
ESR - 9 (4-24)

Glucose 4.8 (4.2-6.0)

Iron - 15.6 (8-30)

Kate Collins67 said:I don't see any mention of protein on this urine test from Fran Mihaljević...

Could you list the diagnoses from both of Fran Mihaljević's reports?

How many days of antibiotics did you take—and how long after the fever broke, plus which antibiotic were you on if they switched things up? Also, do you have any cats?

What are the specific markers for protein? I'm pretty sure I haven't forgotten, but still...

I was on Silapen for 8 days—1500mg three times a day—though while I was in the hospital, I received Sumamed via IV, along with 1500ml saline infusion and injections of Ketorolac and Bipenicillin.

Two days after starting the treatment, my fever broke completely... I had a slight temperature on 6/7, but after that, everything seemed fine.

Diagnoses:

07/01: R50.8 Fever status
G44 Other headaches, L04 Acute lymphadenitis

07/03: Streptococcal pharyngitis

I do have cats, which is why we ran tests for Toxoplasma and those other two or three things...

Usually, they just list the proteins.

Was one of those other two items a serology test for Bartonella?

Were these results from 2011 taken while you were running a fever or dealing with some other acute flare-up—or was this just a routine lab workup?

Kate Collins67 said:It usually just lists proteins.

Was one of those other two items a serology test for Bartonella?

It’s Toxo, Bartonella, EBV, and CMV...

My doctor noted 3.7, asking me to get these tests done:

CBC with differential during fever, electrolytes, CRP, glucose, BUN, creatinine, AST, ALT, GGT, LDH, Na, K, Cl,
and a urinalysis...

I think that was what I wrote down myself...

Wait, hold on... I just noticed something in the medical history from 07/03. Let me type this out.
I hadn't mentioned it before because I assumed everything was already covered in the lab results, but I see they actually noted the antibodies too...

SE 68, CRP 53.2, glucose 5.4, BUN 5.0, creatinine 76, bilirubin 5.0, AST 20, ALT 20, GGT 33, LDH 187, Na 134, K 3.9, Cl 98
urine biochemistry: protein 1, ketones 4, sediment: 5-6L, lots of RBCs

I'm thinking this might be related to the urine results, right?...