Someone Had Inquired About Lab Values & Interpretation: here they are.

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erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 6/15/2006 10:29 AM (GMT -7)   
A while back I read a post by someone who wanted to know about rheumatic panels and ANA, CRP and blood work and what they are & what they mean.   confused  I just can't find that thread!  confused But here are some regular rheumatic labs and there signifigance:
 
   *RPR:  a test for syphilis; but this is ordered for some weird reason. false positives for syphilis may show up in Lupus & RA.
 
   *ANA:  performed to check for autoantibodies in pts suspected to have Lupus, RA, Mixed Connective Tissue Disease, Sjogrens, Scleroderma.  This test is not conclusive to any specific disease; it is thereafter titered for antibodies.
 
   *RF:  it's a macroglobulin associated with RA. a good detector for Dx of RA.  normal refernce values are 0-20.
 
   *Anti-RNP:  is elevated in 40% of SLE and MCTD pts (lupus and mixed tissue disease)
 
   *Anti-Sm:  SLE, MCTD, Sjogrens
   *Anti-SSA: Sjogrens
   *Anti-Scl-70:  Scleroderma
   *Anti-Jo:  Polymyosistis    
 
So hopefully the person who inquired about this finds this! But it is useful as a guide to figuring out whatthe heck is on your script when you get blood work done.
 
Sincerely,
Erin


Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


RAGirl
Regular Member


Date Joined May 2006
Total Posts : 28
   Posted 6/15/2006 10:40 AM (GMT -7)   
I'm not the person who inquired about this but thanks for posting.  Good info :)

yalinda
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Date Joined May 2006
Total Posts : 1179
   Posted 6/15/2006 11:03 AM (GMT -7)   
erin, this is a copy of my may post?.......i just went back and copied it for u but like i said on the other post i am cing my pcp this pm....night night ...again ~*yalinda

no rush on this it is a holiday weekend and you enjoy it the best you can,do not do research on my stuff i would feel like a crumb if you did

i got a copy of all my blood work and am going to go through it online a try to understand some stuff i am posting fyi but do not do anything more this holiday weekend that is not my intent please rest and enjoy it. this post will stay til next week and then if u have info to share and feel up to it by all means share.

here is the following out of limit results
wbc high
hgb low
mchc low
#gran high
%lymph low
segs high
lymohs low
bun high
k low
co2 high
alt low

i do not have a clue what any of this is but i will look online now and tryto figure out myself. please just wait til tuesday to follow up i am not dying and it can wait if u need to research anything.

thanks for your concerns and i hope you feel better soon..... enjoy your weekend please thanks linda

erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 6/15/2006 11:22 AM (GMT -7)   
a hah! will get to! thanks...i knew i wasn't imagining it. believe it or not....this does make sense on how say for instance the granulocytes are high...the lymphocytes low, it works like that with certain immune responses.
will interpret no prob! :)
Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 6/15/2006 6:11 PM (GMT -7)   

Here we go! :-)

  • elevated WBCs: of course, these are the dudes that fight infection. (aka leukocytes) normal range is 4.5 to 10.5;  so elevation could mean you have a new infection, tissue injury, also all of the Autoimmune disorders initially may show an elevated WBC count.
  • elevated Segs: another part of the leukocyte count. normal ranges 50 to 62; increases can detect inflammation, RA, vasculitis, gout, metabolic disorders like diabetes.
  • Lymphs % low:  normal ranges 25 to 40; if it decreases it can detect steroid use, chemotherapy induces this, anemia, immune disorders. 
  • decreased Hemoglobin: this guy carries the good stuff. Oxygen and CO2. normal ranges for women is 12 to 16; decreased Hb can mean iron deficiency anemia,thalassemia, SLE, reactions to medicines.  this also looks at the chances of anemia or the severity of it.
  • low MCHC: Mean Corpuscular Hemoglobin. normals range 26 to 34; if it's low it could detect anemia. MCHC is used mostly to determine an anemia called microcytic anemia.
  • elevated BUN: (blood uria nitrogen) this thing tells us how our renal system is doing. it's an enzyme! normal ranges 6 to 20; an increase could detect stress, dehydration, congestive heart failure, they use it to look at heart attacks, UTI's, urinary obstructions, steroid use, diabetes & excess protein intake (the BIG HOOHA about the whole ATKINS thing being dangerous eyes ).
  • decreased Potassium (K+):  yeah the favorite electrolyte of the bod! :-) it's the primary cation for nerve conduction, muscle function & acid base balances! normals are 3.5 to 5.2 (you see there's not too much leeway...that's for a good reason because potassium is important!) hypokalemia is a very low K+ reading.  this could mean EKG changes, vomiting, diarrhea, sweating, starvation & diuretic overuse. major thingis to keep an eyeball on heart function on this one.
  • low Alt: Alanine Aminotransferase. it's another enzyme concentrating in the liver. mainly used for medicine tolerance. normals for women range 7 to 35; you really don't wanna worry about low ALT.  the high is what you worry about.  low Alt can come from NSAIDs, salicylates and meds.
  • CO2 elevated: this might be a fluke. depending on how long the blood sits. emphysema, COPD can cause elevations. 

So as you see, nothing is exactly conclusive & direct.  I hope this is at least useful for the most part.  As you see, I like labs! I think they're cool. scool And they're fun to analize.

Anything else just let me know.

Take care,

Erin


Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


yalinda
Veteran Member


Date Joined May 2006
Total Posts : 1179
   Posted 6/15/2006 6:40 PM (GMT -7)   
thank you so very very much!!!! *~yalinda
 
my pcp has referred me to another pulmonary doctor as he is uncertain a ctscan 2 years ago only showed 2 non specific nodules on my left lung and now i have 7 total on both lungs.... still non specific but since the visit was so scatter brained he is sending me for a ssecond opinion..... he also wants me to get a second opinion on my RA treatment? i thnk mainly because he is unfamiliar with all the ins and outs of it and i was diagnosised by my inflamation levels sed etc and symptoms and not a positive RA level. i told him that i was told my blood work and xrays confirmed the RA and that is why the rhuemmy put me right away on the mtx now he is questioning it so i am too! ugh! here we go again into pandoras box! ~*yalinda

elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1744
   Posted 6/16/2006 6:34 PM (GMT -7)   

Hey Yalinda,  I don't know much about methotrexate, but they did not want to put my mother on that drug (she had mctd) because she had developed interstitial lung disease.  Methotrexate can be very very hard on your lungs.  Perhaps that's why your doctor wants you to have a second opinion for the spots on your lungs.  Maybe MTX could make them worse?  In any case, second opinions never hurt.

Elcamino


Current dx: Rheumatoid Arthritis
Suspected dx: Early Lupus/MCTD
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 6/16/2006 8:40 PM (GMT -7)   
hey yalinda,
in fact...with everything else there, a negative RF value might not ever show up!  they can still determine RA even without an RF titer.  in many cases, there is no RF lab for patients yet everything else is there.
 
another look @ the nodules is a great idea.  in fact, i would have that marked in my calender as being checked at the least yearly!  lung nodules can indeed be a part of RA.
 
how was your TB skin test? anything pop up? (no pun intended) lol.
 
maybe it's time for a TNF medication in adjunct to MTX.
 
sincerely,
erin 
Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


yalinda
Veteran Member


Date Joined May 2006
Total Posts : 1179
   Posted 6/17/2006 6:37 AM (GMT -7)   

no TB here! it was negative and yes my doctor was concerned about the lungs and mtx thing!  i guess a second opinion on both is a good thing just feel like i am betraying someone..... i am kinda a person who never INTENDS to hurt anyone and feel like i am sneaking behind these doctors backs.... i know it sounds crazy and i understand the logistics and everyone does it but i have trouble and guilt, ya guilt, thats it!  i always worry about what others think and feel guilty if i think i might hurt someone else because i am sensitive... anyway enough therapy about my personal insecurities lol  i am going to do it esp the lung thing cuz her was not a good doctor but i like my rhuemmy, but i know like doesnt cut it when my body is at risk with a strong drug.... i hope i dont end up lost and confussed in this ordeal  i felt like at least i had answers for all the pain and now i feel like i am looking with more questions again confused

oh well i will not fret yet!  yesterday is gone tomorrow, will be, and today just is!  no matter what i think, so be it! 

thanks everyone i may need support on this in the future if i procrastinate too much  ~* yalinda


yalinda
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Date Joined May 2006
Total Posts : 1179
   Posted 6/17/2006 6:40 AM (GMT -7)   
erin when u get the chance  my ESR and C reactive protiens are high too..  what r they?  ~*yalinda

erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 6/17/2006 9:56 AM (GMT -7)   
mornin' yalinda,
aaaaaaahhhhhhhhhhh...never feel like you are NOT entitled to have someone else look at this!  many docs SUPPORT the ideas of having someone else look at a case!  this is one area where one should not feel like they are backstabbing/cheating/ or made felt guilty by "seeing" someone else.  IT'S NOT LIKE HAVING AN AFFAIR! tongue lol. hah!
you'll do what's right because your gut will tell you what to do and when.  you're already in the right mind set. 
 
CRP
C-Reactive Protein:  During ANY inflammatory process, this specific abnormal protein appears in the blood.  It is virtually absent in healthy people.  CRP can increase dramatically after examples such as: trauma, infection (bacterial), inflammation, surgery & neoplasms.  Normal is less than 0.8 mg/dL
Typically the traditional test for CRP is elevated in RA, Rheumatic fever, post-operations, myocardial infarctions (heart attacks), bacterial and viral infections.  CRP is a little but better at looking at inflammationthan the ESR.
 
Erythrocyte Sedimentation Rate (ESR)
This is when they gather your blood in the tube & they let it clump!  So basically it measures the rate at which the red blood cells settle out of anticoagulated blood (you'll see some goop in the tube the phlebotomist uses for this test) in 1 hour.
So the faster the blood cells fall the higher the ESR will be.
It's not a real diagnostic tool, rather just a useful tool.
Normal women: 0 to 20 and over 50 y/o 0 to 30
Normal men:  0 to 15  and over 50 y/o  0 to 20
Most useful to pinpoint or start the diagnoses of RA, polymyalgias, Lupus, pregnancy, infections, thyroid disorders, and like everything under the sun!  cool   So again ... very no specific.
 
:-)  Erin
Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


yalinda
Veteran Member


Date Joined May 2006
Total Posts : 1179
   Posted 6/17/2006 11:48 AM (GMT -7)   
as always thanku  for all the info.  just woke up from a long summers nap! best way to digest the weekend dose of my mtx .... was too hot to stay outside  lol  i prefer high 70's with sun and a light breeze.... going to dish up a virgin margarita    cheers everyone   ~*yalinda yeah
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