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

For the last two or so years, my CRP has been consistently high, usually sitting somewhere between 30 and 50. Then, about two weeks ago, I went in to get a pneumonia vaccine, having no idea there was some kind of inflammation going on in my system. My CRP shot up to nearly 100. It triggered a reaction too—my arm where I got the shot was incredibly painful, and I hit a fever of 103.4. I guess I'm wondering what could be driving this elevated CRP and what my next steps should be? My primary care doctor doesn't seem concerned, but I can't help feeling like this isn't exactly normal.
P.S. Just so you know, I had my spleen removed following a car accident about six years ago.

steeleagle152 said:For the last two—well, two and a half years—my CRP has been elevated. It usually sits somewhere between 30 and 50. About two weeks ago, I went in for a pneumococcal vaccine, completely unaware that I had some kind of underlying inflammation. My CRP was nearly 100 at the time. It triggered quite a reaction—intense pain in the arm where I got the shot and a high fever (39.6°C). What could be driving this elevated CRP, and how should I proceed? My GP doesn't see any issue here—but to me, it feels far from normal.
P.S. Just a note—I had my spleen removed following a car accident six years ago.

What prompted the pneumococcal vaccine? Was there an underlying health condition?
And no—it isn't normal for CRP to stay consistently elevated—unless you're testing during an active bout of illness, in which case a spike is expected due to infection (which makes sense).

@Bryan Barnes2, can you help me out here? I need some clarification.
So, I’ve got this kid—the one with the persistent issues on those last few pages, dealing with constantly swollen lymph nodes for almost two years now.
Every couple of months, we’re doing a CBC, a differential, and a peripheral blood smear.
But why on earth are the values on these tests so inconsistent? We’re pulling blood from the exact same kid, yet the results keep shifting.
For instance, the counters always pick up atypical lymphocytes—sometimes it's 2, sometimes it's 6, sometimes it jumps to 8...
Yet, on the CRP, nothing ever shows up.
And when looking at the peripheral smear, those rouleau formations are always present.

On top of all that, the kid has no IgA—or if he does, it's negligible, like below 0.05.
I’ve been digging through the internet, and apparently, that could be a massive red flag if he ever needs a transfusion. But get this: when he had surgery under general anesthesia, neither the anesthesiologist nor the surgeon gave a single damn about it. They didn't even mention it in the charts! Meanwhile, I’m sitting there like a total amateur, having to sign off on a whole list of risks, including bleeding, since it was a neck surgery. So, how much does this actually matter or pose a real danger? Should I be making a huge deal out of it in situations like that?

(Right now, the doctors are suspecting ALPS, or they're waiting to see if it develops into CVID because his IgG fluctuates, and his DN T-lymphocytes are right at or slightly above the upper Ref unit.)

Sandra Vaughn50 said:So why did you get the pneumonia vaccine? Was there some underlying health issue or something?

And no, it isn't normal for CRP to stay elevated all the time, unless you're testing because you suspect an infection, in which case a spike is just what happens (which is expected).

I got vaccinated against pneumonia because I don't have a spleen, so I have to get the shot every five years. Before six years ago—when I was in a car accident and had a splenectomy—my health was actually pretty fine. I'm 48, I don't drink or smoke, but I do have hypertension.

Bloodwork results:

Metabolites and Substrates
Glucose 5.3 (4.40-6.40)
Bilirubin 22H (3.0-20.0)
Creatinine 58 L (64-104)

Enzymes
S-AST 52 H (11-38)
S-ALT 79 H (12-48)
s-GGT 74 H (11-65)

Electrolytes
S- Potassium 3.9 (3.9 - 5.1)
S- Sodium 139 (137 - 146)

Lipids
S- Total Cholesterol 7.4H ( S- HDL Cholesterol 1.28 (>1.0)
S- LDL Cholesterol 4.91H ( S - Triglycerides 2.62 H (1.7)
On top of this, I've been diagnosed with high blood pressure (160/100)

I'm overweight (5'3" and 5'9" approx)

My doctor put me on Allopurinol and Prilen.
I also have an abdominal ultrasound scheduled.

Since obesity is my main issue, I've started dieting and ramping up physical activity.
I've dropped about 11 lbs in the last two weeks.
That basically means I'm burning roughly 1,000 calories at the gym daily while only eating about 1,200 calories total.

My diet revolves around about 5 ounces of meat (turkey, fish) every other day—alternating that with 18 ounces of low-fat cottage cheese—plus an equal amount of peas, fruit, and veggies.

What I want to know:
1. An explanation of these results.
2. Can I get back to my baseline through diet and meds? Basically, is there a chance I won't need to be on medication indefinitely in about 6 months?
3. Is losing weight this fast actually dangerous?
I'm particularly worried because I read online that both peas and meat are bad for uric acid levels—but if I cut them out, I can't lose weight. I can't survive on just cottage cheese. This current setup is actually tasty, too; I designed the meal plan myself.
Thanks in advance

We're looking at a case involving a 28-year-old guy. About six months ago, he was diagnosed with a malignant testicular tumor that had already spread to his lymph nodes and spleen. He went through several rounds of chemo, but nothing worked. Later, they sent a tissue sample off to another hospital for testing, and the pathology report came back calling it an unidentified malignant sarcoma-type tumor. Right now, he’s just at home, starting to deal with real pain, and everyone is keeping him in the dark. What does a finding like this actually mean? Are we definitely talking about a sarcoma here?
Best,

So, I've finished 11 days on Clindamycin, but my CRP is still high. I guess I'm not really sure what to make of it... I'm heading back for more blood work in two weeks, and if the CRP is still elevated then, my doctor will probably refer me to an internist.

Could someone help me make sense of these blood pressure Holter results?

The Results:
Most readings were technically valid (96%).
Your average 24-hour arterial blood pressure was 134/73 mmHg (Normal is 80; Hypertension is >130/80).
Your average daytime arterial blood pressure was 129/71 mmHg (Normal is 85 mmHg; Hypertension is > 140/90
mmHg).
Your average nighttime arterial blood pressure was 150/81 mmHg (Normal is 70 mmHg; Hypertension is >125/75 mmHg).
Moderate variations in pressure were noted during the measurement period.
Max systolic pressure was 171 mmHg, and max diastolic pressure was 95 mmHg.
Reverse dipper pattern observed during the night.
Percentage of values above normal: 20% of daytime systolic and 2% of daytime diastolic values, plus 100%
of nighttime systolic and 42% of nighttime diastolic values (clinically significant if >40%).
Jane Kasumović, MD

cosmicheron22 said:Could someone please walk me through these blood pressure Holter results?

Results
The vast majority of measurements were technically valid (96%).
The average 24-hour arterial blood pressure is 134/73 mmHg (normal is 80, hypertension is >130/80).
The average daytime arterial blood pressure is 129/71 mmHg (normal is 85 mmHg, hypertension is > 140/90
mmHg).
The average nighttime arterial blood pressure is 150/81 mmHg (normal is 70 mmHg, hypertension is >125/75 mmHg).
Moderate variations in pressure were observed during the measurement period.
The maximum systolic pressure was 171 mmHg, and the maximum diastolic pressure was 95 mmHg.
A reverse dipper pattern was noted during the night.
The percentage of values exceeding the normal range is: 20% for daytime systolic and 2% for daytime diastolic, as well as 100%
for nighttime systolic and 42% for nighttime diastolic (clinically significant >40%).
Jane Kasumović, MD.

Since I don't have the full picture—such as your other medical history, existing comorbidities, or previous diagnostic workups—I can only speak to what these numbers suggest. Looking at this data in isolation, it seems to point toward essential hypertension. Therefore, it would be highly prudent to schedule a follow-up appointment with Dr. Kasumović (😁) or perhaps consult with your primary nephrologist to discuss these findings further.

Low Alkaline Phosphatase
I wonder what could be causing this...

Nicholas Mendoza60 said:Low Alkaline Phosphatase
What kind of reason could this be?

Well, there are probably about 300 different reasons why that might happen.

Keith Gonzalez said:There's gotta be at least 300 reasons why...

Is there like, any basic reason for this?
How would you even go about looking into it?...

Nicholas Mendoza60 said:Are there any fundamental reasons behind this?
How should one go about investigating it?

In and of itself, such a result doesn't necessarily signify anything of consequence. It truly depends upon the broader context—things like your age, the interplay with other lab results, or even the specific reasoning why your physician requested the test in the first place.

Carol Lopez23, could you take a quick look at those questions I posted a few posts up?
We've been dealing with this whole mess of swollen lymph nodes with my kid for two years now, and honestly, the more perspectives I can get my hands on, the easier it makes it to figure out what we should actually do about it.
Thanks.

Emily Ortiz27 said:Bryan Barnes2, could you help me out with an explanation?
My little boy, who has been dealing with consistently enlarged lymph nodes for nearly two years now, is currently undergoing testing.
Every few months, we have him undergo a CBC, a differential, and a peripheral blood smear.
Why are the values on these results inconsistent? Even when drawing from the same blood sample, the findings seem to vary.
For instance, the automated counters frequently detect atypical lymphocytes—sometimes it’s 2, sometimes it’s 6, or even 8...
But they never show up on the CRP.
However, on the peripheral smear, rouleaux formations are always present.

Furthermore, the child lacks IgA (or has a negligible amount, specifically below 0.05).
While searching online, I read that this could pose a significant risk during a potential transfusion. Yet, when he underwent surgery under general anesthesia, neither the anesthesiologist nor the surgeon seemed to give it any thought; they didn't even note it in his records (whereas I, as a wannabe, had to formally sign off on a whole list of risks, including bleeding, since it was a neck surgery). How critical or potentially dangerous is this situation? Should it be highlighted in such circumstances?

(In the US, doctors are currently suspecting ALPS or are waiting to see if it develops into CVID, as his IgG fluctuates and his DN T-lymphocytes are right at or slightly above the upper Ref unit.)

An automated counter is by no means perfectly precise, particularly when dealing with a low number of detectable components. The same logic applies to the cytological examination. The most important thing is that the values do not deviate excessively from the overall clinical picture, which is why these tests are performed repeatedly.

It is likely due to anaphylaxis. However, a transfusion can be managed if the blood is prepared in advance.

You will only know for certain by consulting his primary pediatrician. It is certainly something that warrants close monitoring.

Thanks!
On the last few cytology smears, they actually spotted some Rouleaux formations.
Is there any way that could be linked to his current situation, or should I just hope it was a fluke—like maybe the smear was just too thick or something?

I would venture to suggest that this phenomenon is more closely tethered to the underlying autoimmune condition currently present. That being said, it is certainly possible for such a result to surface even in perfectly healthy individuals. As you review the full suite of lab results and diagnostic tests, I would recommend keeping that possibility in mind; however, I am quite confident that your pediatrician will draw your attention to it should the "pattern" appear anything out of the ordinary.

Thanks

Can someone tell me if this is actually dangerous:
Protein electrophoresis:
Total protein 69
Albumin 55.7 (56-66)
Alpha1 globulin 5.4 (3-5)
Alpha 2 globulin 12 (7-12)
Beta globulin 14.2 (8-13)
Gamma globulin 12.7 (11-19)
Albumin 38.4 (40.2-47.6)
Alpha 1 globulin 3.7 (2.1-3.5)
Alpha 2 globulin 8.3 (5.1-8.5)
Beta globulin 9.8 (6.0-9.4)
Gamma globulin 8.8 (8.0-13.5)
Albumin/globulin 1.26

AST 18 (8-30)
ALP 92 (54-119)
ALT 17 (10-36)
GGT 28 (9-35)

Total bilirubin 7 (3-20)
Creatinine 59 (49-90)

I'd love an opinion from someone who actually knows what they're talking about, thanks.

What could possibly be the danger involved here, and what was the underlying rationale behind requesting those specific test results in the first place?