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

I’ve got a question about mono too.

So, my EBV IgG came back positive at 99.97% and my CMV IgG is at 25, but both IgM tests were negative. What’s the deal with that?
I was sent in for more testing because my liver enzymes are through the roof—some of them are triple the normal limit. Back in mid-February, I was stuck in bed for three days thinking I just had a nasty bout of the flu.

On top of that, I’ve been diagnosed with hyperthyroidism, though my ultrasound and scintigraphy results actually look fine. Is it possible that a past bout of mono totally threw my thyroid out of whack?

Thanks!

Betty Gray36 said:Enteropathic arthritis often involves swelling in multiple joints—polyarthritis. It’s also frequently linked to intestinal diseases. In my case, though, there’s no polyarthritis and no history of bowel issues. I’ve never had gut problems, and my tests—urinalysis, Chlamydia, Ureaplasma, Mycoplasma swabs, and stool cultures—all came back clean. I can't figure out how this fits the puzzle.
I apologize for the barrage of questions, but I'm genuinely lost. Is there any chance of some kind of mechanical failure that wouldn't show up on an MRI?

First off, enteropathic arthritis doesn't strictly have to manifest as polyarthritis. That's just one variation. While it often coincides with the onset of inflammatory bowel disease (IBD), sometimes it shows up before the GI issues even start. For now, let's assume this doesn't look like Type 1 enteropathic arthritis, where you have a genetic predisposition.

If we are looking at reactive arthritis, however, keep in mind that many patients don't present with prior symptomatic infections. So, having zero history of gut or urinary tract issues doesn't rule out reactive arthritis.

Finally, just because you have a genetic predisposition doesn't mean you are destined to develop the disease.

Michelle Barnes53 said:The reason for the urine culture was follow-up with a urologist after kidney surgery; if the bacteria count hits 10^5 or higher, I'm on antibiotics.
This time, there was burning, frequent urination, and even some bleeding. My GP thought it was standard procedure to run a follow-up culture ten days after finishing Klavox. Since doctors here tend to hand out antibiotics quite easily, I felt I needed a second opinion. 🙂

Frequent urination caused by diuretics is one thing; incontinence is quite another. It might be worth asking for a referral to an infectious disease specialist.

Michelle Morris74 said:Thanks for the reply. We just finished the bone marrow biopsy, and I've included the results below. If you have a moment, could you help me make sense of this? Is there anything more we can determine now?

While these findings don't point toward multiple myeloma, a single bone marrow biopsy isn't enough to rule it out entirely. You also have to look at this critically, especially since the marrow is hypocellular—meaning the cell count is low. For now, the full picture remains unclear.

mellowmoose11 said:Could someone please explain these urine culture results?
The culture was ordered due to frequent urination.
Result: Morganella morganii
AM AMC CTB GM CIP NOR SXT FM LVX CFM CN
0 0 3 3 3 3 3 0 3 3 0
Thanks in advance!

The urine sample grew a specific bacterium often seen in patients who have been hospitalized, had a catheter, undergone surgery, or deal with kidney stones.

The number 3 indicates which antibiotics the bacteria are sensitive to. Some of these might only be administered intravenously in a hospital setting, while others can be taken as oral tablets.

Which treatment path is chosen and which antibiotic is used depends entirely on the clinical presentation, existing health conditions, and other complicating factors.

Laura Lopez47 said:Hello. I just got my blood work back and wanted to run these numbers by you all for some perspective. Here is what I’m looking at: ESR: 2 (Ref: 4-24) L Neutrophils: 41% (Ref: 44-72) L Eosinophils: 7.4% (Ref: 0-7) H Eosinophils (absolute): 0.50 (Ref: 0.00-0.43) H Everything else came back normal. I'm a bit concerned about the low ESR, especially since this pattern has been consistent for nearly three years now. My levels tend to fluctuate like this—sometimes high, sometimes low—including my lymphocytes. Given that this has been my "normal" for three years, is this actually pathological? Should I be pushing for more testing? Thanks.

ambernomad73 said:Could you please help me make sense of these blood work results? Neutrophils: 34.6 (Ref: 44-72) Lymphocytes: 48.9 (Ref: 20-46) Eosinophils: 7.1 (Ref: 0-7) Lymphocytes: 4.34 (Ref: 1.19-3.35) Eosinophils: 0.63 (Ref: 0.0-0.43) Alkaline Phosphatase: 20 (Ref: 50-153)
Everything else looks solid. All other parameters are in order.

You're asking for feedback on lab results, yet you've missed the essentials: a) there's no description of symptoms or the actual reason these tests were ordered, and b) you're looking for an interpretation of the differential without providing the total WBC count. Without that context, commenting on these findings is impossible.

Laura Lopez47 said:I'm trying to make sense of these parameters: LUC, LI, and MPXI.
Also, why are Lymphocytes, Monocytes, Neutrophils, Eosinophils, and Basophils listed in two different types? Thanks.

I believe I covered this on the previous page:

LUC stands for large unstained cells—this includes atypical lymphocytes and blasts. An elevated reading might point toward the presence of blasts (immature white blood cells) or atypical/reactive lymphocytes (cells that enlarge due to antigen stimulation, such as from viral infections like EBV, CMV, or viral hepatitis).

MPXI represents the mean peroxidase index. A high value could stem from megaloblastic anemia, an infection, or certain types of leukemia. Conversely, a low value might indicate congenital or acquired peroxidase deficiencies, or specific leukemias.

LI is the lobularity index. If this is low, it suggests the presence of immature leukocyte forms, specifically blasts.

That is simply how the equipment in that specific lab operates; hence, the results look a bit different from the standard format you might expect.

Megan Ross36 said:Can someone help me make sense of these mono results?

View on imgur

I'm asking because our CBC shows only slightly elevated relative lymphocytes (not reactive ones!) and everything else looks fine, including liver enzymes (ALT; AST).

What does "elevated relative lymphocytes" actually mean? Are you saying the lymphocyte percentage in the differential is high?

The serology suggests this is most likely a past infection. Generally speaking, this specific test is less definitive than a full four-parameter panel. This test attempts to distinguish EA IgG from VCA IgG, which matters if the clinical symptoms are ambiguous. Ultimately, any interpretation relies on the patient's actual condition. If things aren't clear, there are always further diagnostic steps to confirm whether an active infection is actually present.

Karen Alvarez40 said:I have a question regarding mono as well.

My EBV IgG is positive (99.97) and my CMV IgG is (25). IgM levels are negative. What’s the takeaway here?
I was sent for testing due to elevated liver enzymes (some were three times the normal limit). Back in mid-February, I spent three days in bed thinking I just had the flu.

I've also been diagnosed with hyperthyroidism (though ultrasound and scintigraphy came back normal). Is it possible a previous bout of mononucleosis messed with my thyroid function?

Thanks!

The data required for a proper assessment of EBV status is missing. Looking at "EBV IgG" alone doesn't tell us much when you need to evaluate all four parameters: VCA IgG, VCA IgM, EA IgG, and EBNA IgG.

Maria Fisher46 said:First off, enteropathic arthritis doesn't always have to be polyarthritis. That’s just how it works sometimes. It’s true that it often shows up right alongside inflammatory bowel disease or maybe a bit later on, but occasionally, it can actually pop up before any gut issues even start. But, for now, let's just say it doesn't look like Type 1 enteropathic arthritis, where there's a specific genetic predisposition involved.

If we're talking about reactive arthritis, though, you have to keep in mind that a certain number of patients don't actually have a preceding symptomatic infection. So, just because you haven't dealt with any gut or urinary tract problems in the past, it doesn't necessarily rule out reactive arthritis.

And finally, having a genetic predisposition for something doesn't mean you're definitely going to develop it. I guess it just means the possibility is there.

Thanks so much for the response. So, with reactive arthritis, it isn't necessarily linked to some kind of bacteria? All my tests regarding that came back normal...
Thanks again for clearing things up. 🙂

Maria Fisher46 said:We’re missing the actual data needed to figure out what's really going on with the EBV status. Just seeing "EBV IgG" by itself doesn't tell me a thing when you've got four different markers to juggle: VCA IgG, VCA IgM, EA IgG, and EBNA IgG.

The lab only ran exactly what I asked for: EBV IgM and IgG, plus CMV IgM and IgG.
So, are you guys saying I should go back and get more tests? Honestly, I don't get why they didn't just do the whole panel from the jump.

Betty Gray36 said:Thanks for the reply. Isn't reactive arthritis linked to some kind of bacteria? All the tests done regarding that came back clear...
Thanks again for clarifying everything 🙂

No, reactive arthritis is indeed tied to bacterial triggers, but sometimes the actual infection remains undetected. In rheumatology, nothing is ever a hundred percent certain.

Karen Alvarez40 said:They only ran what I listed: EBV IgM and IgG, plus CMV IgM and IgG.
So, you’re suggesting more testing? Not sure why they didn't just go straight to that.

In this instance, the testing was somewhat limited, focusing only on distinguishing IgM and IgG antibodies. Generally speaking, if IgM is negative and IgG is positive, we're looking at a past infection. However, interpreting EBV results isn't always straightforward; findings can be ambiguous. In those cases, running a more comprehensive panel is the prudent move.

As for transaminases, they typically spike during the acute phase and usually normalize within six weeks in most scenarios.

Whether to pursue further EBV investigation depends entirely on the clinical picture, previous labs, and current symptoms. It would certainly be wise to check viral hepatitis markers as well, if that hasn't been done already.

I am requesting an interpretation of these gluten enteropathy screening results. I am undergoing testing due to a positive family history.
IgG 9.93 g/l
IgA 2.59 g/l
tTG-IgA 5 U/ml
AGA-IgA 2 U/ml
DPG IgA 4 U/ml
DPG IgG 20 U/ml (borderline 15-20)

Is further diagnostic workup required?

Maria Fisher46 said:Whether you need to dig deeper into an EBV infection really depends on how you’re actually feeling, what your previous labs looked like, and your overall clinical picture. Honestly, I’d also suggest running markers for viral hepatitis if you haven't already.

My hepatitis results just came back today and everything is negative.
Following my gastroenterologist's advice, I still need to get tested for alpha-1 antitrypsin, antinuclear antibodies, and serum copper. I have my appointment at the end of the month, so I'll bring those results straight to him. Does anyone know what exactly those tests are looking for?

It’s been two months since that "flu" episode (those were basically the only symptoms I had that could possibly link back to mono), and my full blood panel showed these transaminase levels: AST 68, ALT 139, GGT 80, ALP 201, and total bilirubin at 17. It feels like they should have started trending back toward normal by now, right?

Everything else fell within the normal range, except for my red blood cell count, which was slightly elevated at 5.24.

Hey everyone, could you guys take a look at these two blood panels for me? One was done back on Jan 22, 2015, and the other on April 22, 2015. It looks like some of my numbers are constantly dipping low while others are always spiking up. Is this anything to worry about? I’ve been dealing with hypothyroidism, but I'm not actually on any meds for it right now. Just grabbed these for a routine checkup.
It's those values that just won't stay steady that have me a bit worried!..
Here are the links to the results!

http://s723.photobucket.com/user/luc...tml?sort=3&o=0

http://s723.photobucket.com/user/luc...tml?sort=3&o=1

Is this result considered extremely high?
CRP 26.7
Referred due to abdominal pain and irregular cycles

Sandra Brooks91 said:Is this result considered really high?
CRP 26.7
Sent in due to abdominal pain and irregular cycles

It’s not off the charts, honestly.
But it definitely flags the need for more follow-up labs and a deeper look into what's going on.
I'd say you should probably touch base with a gynecologist, and maybe even check in with a GI specialist or an abdominal surgeon just to be safe.

I have a question, hoping someone might weigh in.
My iron levels have plummeted over the last two years. Back in early 2014, I was sitting right at the upper limit with a 30. A year later, it dropped to 8.5, and after another seven or eight months, I'm down to 5. My hemoglobin is fine—well within range—and my red blood cell count looks great.
My GP insists everything is perfectly normal as long as the ferritin and hemoglobin stay steady, but I can't help feeling this is a bit odd...

To help us give you the most accurate and helpful breakdown of your results, please include these details when you post your findings:

- full results - Standard X-rays of both knees show normal bone structure and mineralization
Joint spaces—both the femorotibial and patellofemoral areas—look normal too.
No major signs of wear and tear or degeneration.
There is some mild, chronic enthesopathy at the quadriceps tendon on both sides.

The X-rays of the lumbar spine show a right-sided scoliosis at the thoracolumbar junction, along with a flattening of the natural curve (lordosis), though the posterior intercorporeal line remains intact. Vertebral body heights and mineralization look fine. The disc space at L5-S1 is slightly narrower in the back, but there aren't any clear signs of disc osteochondrosis.
Small facet joints are visible and look okay.
Spinous and transverse processes are normal, with no signs of spondylodestructive changes.

- reference ranges - none

- age - 32

- reason for testing (your symptoms)- Pain in my right leg. It felt like it locked up—pain in the calf, behind the knee, and even a bit behind the thigh. My tendon felt really stiff. I hadn't done anything intense, so it was pretty weird.
It lasted about a week before I saw my doctor, who sent me for X-rays.
The pain actually cleared up after a few days, but since I already had the appointment set, I went ahead with the X-rays. Those are the results above.

- brief medical history - Flat feet
- other - nothing significant

So basically... what's going on with me??

Maria Fisher46 said:First things first—enteropathic arthritis doesn't always have to be polyarthritis. That’s rule number one. Sure, it usually shows up right alongside inflammatory bowel disease or maybe a bit later, but sometimes it actually pops up before the gut issues even start. But let's just say, for now, it doesn't look like Type 1 enteropathic arthritis, where you'd have that specific genetic predisposition.

If we're talking about reactive arthritis, though, you should know that a certain number of patients don't actually have any prior symptomatic infections... so, just because you've never had issues with your gut or urinary tract, it doesn't mean you can rule out reactive arthritis.

And finally, just because you have a genetic predisposition for something, it doesn't mean you're definitely going to develop the actual disease.

There's a big difference between frequent urination caused by taking diuretics and actual incontinence. It might be a good idea to have an infectious disease specialist take a look at you.

Doc, just so you know, my issue with contaminated urine culture samples is sorted, so I'm telling you this so you can decide whether to use the results or not. Last week I went back in for another sample, but this time I didn't sit there and let them explain the procedure to me for the millionth time... instead, I was the one explaining to *them* how I could provide the most optimal sample. When I mentioned that my first morning pee is usually around 4 AM, some cleaning lady wandering around the lab goes, "Well, I guess you should just stick the sample in the fridge so bacteria doesn't grow in the heat between then and 9 AM." Good grief... and I was busy heading to school. Thanks for all the effort, cheers, Mary

Hey everyone. So, I ended up in the ER the day before yesterday because of some intense pain in my lower right abdomen. The doctors ran some blood and urine tests, but basically told me it "wasn't their department" and that I should follow up with my primary care physician. I was in agony yesterday, though the pain has died down today—I can barely feel it now. It definitely flares up after I eat.

Here’s the catch: I don't have health insurance right now. I missed the window to renew it, and since things are absolutely slammed with work at the moment, I haven't had a second to get it sorted, which means I can't just head straight to my doctor. That said, the doctor at the hospital mentioned that something in my results looks off. What do you guys think? Is this something serious enough that I need to drop everything, fix my insurance, and see a doctor immediately, or can I afford to wait a few days? Honestly, I'm freaking out, especially seeing that amylase level...

I'm 20 years old and normally I don't deal with any health issues.

Here are the results: View on imgur

Thanks!

That was my experience last week too... maybe we're dealing with some new strain of virus or bacteria, or who knows what else?

Hey there,

So about a month ago, I checked my blood pressure for the first time and it was sitting around 150/100, which was weird because my pulse is usually pretty low, like under 50. On May 1st, I actually woke up feeling this sharp pain in the back of my head, and when I checked my numbers, my BP had spiked to 170/115 with a pulse of 55. I grabbed some aspirin and some over-the-counter stuff to help with the discomfort, and then popped into a local CVS about half an hour later to get a re-check, where it was still high at 150/110. Right after that, I headed straight to the hospital to get everything looked at. I’m only 25, and even though I work a standard 9-to-5 office job, I’ve been getting back into handball lately. Following my primary doctor's advice, I saw a cardiologist on May 9th, 2015, who ran an EKG, a physical, and an echocardiogram. He told me I have borderline left ventricular hypertrophy and basically said I need to cut back on the fats and salt in my diet. My life is pretty fast-paced—I'm constantly commuting between two different cities—and I still go out and grab drinks every other weekend, though I try to balance it all out by hiking, eating better, and staying active. I’ve been monitoring my blood pressure, and it usually hovers around 135/90 with that low heart rate, but sometimes it just spikes out of nowhere before settling back down.
I was hoping maybe someone here could take a look at these results and give me a second opinion, because honestly, this whole thing has really freaked me out, especially since I'm still relatively "young," if you can even call it that these days.
Bloodwork:
http://i62.tinypic.com/72push.jpg
http://i58.tinypic.com/140iyq0.jpg
Internist:
http://i57.tinypic.com/2njydd4.jpg
Echo:
http://i58.tinypic.com/124a2hw.jpg
EKG:
May 4, 2015. http://i61.tinypic.com/e9hf80.jpg
May 9, 2015. http://i62.tinypic.com/350kj74.jpg