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

brightgull95 said:Honestly, you should probably run this by the two specialists you've been seeing. It’s highly unlikely they just gave you some verbal suggestions on the fly; there has to be some sort of written recommendation or clinical note regarding what needs to be done next.

My rheumatologist recommended I get a puncture of an inguinal lymph node and an echocardiogram.
The puncture was performed and the results came back normal, but during the echo, the cardiologist made a mention of the lymph node. I have a follow-up scheduled with my rheumatologist on May 29th.
Do you think I should bring up the lymphoedema specifically with the rheumatologist? I'm attaching the ultrasound report and my blood work here.

brightgull95 said:You should really ask the two doctors you've seen about this directly. There's no way they just gave you verbal instructions without leaving some kind of paper trail or official recommendation somewhere.

Unfortunately, I can't get the image to load properly here.
The report notes heart enlargement.
The aorta looks normal in diameter, and both the pulmonary artery and the pulmonary valve are fine. The chambers of the heart are within normal width ranges.
There is mild concentric hypertrophy in the anterior and posterior walls of the left ventricle, measuring at 1.2cm. Contractility is normal, and both systolic and diastolic functions are performing as expected. No intracardiac masses were found.
There is bilateral swelling in the feet and distal lower legs, which looks like chronic lymphedema.

James Peterson7 said:My rheumatologist recommended I get a puncture of a lymph node in my groin and an echocardiogram.
The puncture was done and everything came back normal, but during the echo, the cardiologist mentioned lymphadenopathy. I've already scheduled a follow-up with the rheumatologist on May 29th.
So, do you think I should ask the rheumatologist about lymphedema? I'm attaching the ultrasound and blood work results here.

Yes, absolutely—ask both him AND the cardiologist who diagnosed the lymphedema in the first place. You had a puncture, sure, but it sounds like the rheumatologist wants a full biopsy (excision) of that node.

brightgull95 said:Exactly. Both my primary doctor and the cardiologist who first identified the lymphedema are on the same page. Even though the puncture results came back clear, the rheumatologist is pushing hard for an actual excision of that node.

So, the rheumatologist is adamant about surgically removing the lymph node in the left groin, even though the puncture biopsy looked perfectly fine.
If I wanted to find a specialist specifically for lymphedema, what kind of medical sub-specialty should I be looking for?

Go see an internist. As for all the other specifics, you really need to grill the two doctors actually managing your care.

brightgull95 said:Just ask an internist. For everything else, you really should sit down with the two doctors managing your case and get the specifics directly from them.

I really appreciate how thorough everyone has been with their answers. At this point, I think my best bet is to just talk to my rheumatologist. My heart ultrasound was actually done over at a private clinic, which was my first real encounter with a cardiologist—up until now, everything has been handled through my rheumatology team.
Thanks so much from the bottom of my heart.

Edward Long64 said:Bumping this thread. I am hoping for some guidance...

Edward Long64 said:Context:

The histology shows an orthokeratotic surface with a normally layered epidermis.
In the dermis, there are sparsemononuclear inflammatory infiltrates located perivascularly. In the deeper dermal layers, one observes
increased scar tissue."

As someone with very little medical knowledge, I would appreciate an interpretation. Could this be something serious? Also, could you explain the bolded terms?

Thank you.

Orthokeratotic—this refers to a slightly thickened stratum corneum that matures normally. Nothing significant here.
Sparse perivascular mononuclear inflammatory infiltrate—essentially just a few lymphocytes around the blood vessels. Subjective and clinically minor.
Increased scar tissue—well, it is increased scar tissue. For whatever reason, it does not indicate anything grave.
The findings are largely non-specific, though pathologists are required to document everything.
Perhaps the most critical detail is missing. I am unsure if you omitted it or if it was simply not noted—if the report does notsuggest granuloma annulare, then we lack the key indicator.

Hi everyone.
I could really use some help if anyone has experience with this.
I've been dealing with high platelet counts for over a year now. They were at 536, then dropped slightly to 517. I've had testing done for JAK2 and erythropoietin and everything came back normal; my diff was mostly fine too, though monocytes were a bit elevated. A sinus X-ray showed allergic rhinitis and inflamed membranes, but I’ve dealt with that chronically. My abdomen, thyroid, and immunoglobulin levels (IgM, IgA, IgE) are all fine, and my iron levels are normal too.
Now, after eight months, I just got more bloodwork back and my platelets are at 560—the highest they've ever been.
I'm honestly lost on what to do next or which specialist to see. I haven't had any viruses or symptoms, nothing unusual lately besides a lot of STRESS.
Does anyone know if stress can actually spike platelet counts? And is it possible for those other results, like the JAK2, to have changed since my last tests?

Thanks so much.

Diagnosed with SCLE—skin lupus—back in 2013. I stay on top of things with regular checkups with my immunologist, and this was my most recent lab work. My SSA RO60 levels are unusually high... they’re definitely elevated, though usually they don't go much past 150.
Normally I get my labs done at Mayo Clinic, but by some stroke of luck, I had them done over at Mount Sinai this time—though the reference intervals are exactly the same...

https://ibb.co/L55pXqb
https://ibb.co/gdDrVR2

Hello there... I was wondering if anyone could weigh in on these lab results, specifically regarding the coagulation panel. It’s for a 7-year-old child...
(K) Leukocytes 6.7 x10^9/L 5.0 - 13.0
(K) Erythrocytes 4.69 x10^12/L 4.00 - 5.00
(K) Hemoglobin 134 g/L 109 - 138
(K) Hematocrit 0.396 L/L 0.320 - 0.404
(K) MCV 84 fL 73.8 - 89.4
(K) MCH 28.6 pg 24.3 - 29.2
(K) MCHC 339 g/L 300 - 350
(K) RDW 14.3 % 11.9 - 16.2
(K) Platelets 249 x10^9/L 150 - 450
(K) MPV 8.1 fL 6.9 - 11.3
(K) Eosinophil granulocytes 11.2 H rel % 0 - 6
(K) Basophil granulocytes 0.5 rel % 0 - 2
(K) Neutrophil granulocytes 50.8 rel % 30 - 72
(K) Lymphocytes 29.9 rel % 15 - 55
(K) Monocytes 7.7 rel % 5 - 13
(K) Eosinophil granulocytes 0.75 H x10^9/L 0.00 - 0.70
(K) Basophil granulocytes 0.03 x10^9/L 0.00 - 0.20
(K) Neutrophil granulocytes 3.42 x10^9/L 1.40 - 8.00
(K) Lymphocytes 2.02 x10^9/L 1.40 - 5.00
(K) Monocytes 0.52 x10^9/L 0.22 - 1.51

COAGULATION
(P) Prothrombin time (ratio) 0.45 L > or = 0.70
(P) Prothrombin time (%) 45 L % > or = 70
(P) Prothrombin time (INR) 1.6 Target range for anticoagulation 2.0 - 3.5