Asked by miya
(Female; 38; extreme fatigue, bone pain in leg, ribs, back shoulder blade and joints, weight loss, poor appetite, hair loss, weakness, mental confusion, impaired memory, seizure history, impaired immune response, Mono at 15 and relapsing/chronic EBV ) on Tue 27, Jul 2010 03:19pm Priced at $29.00
A recent blood test showed high protein levels (8.4), so my doctor ordered a PE and IFE, CBC among other tests to follow-up.
The results of those tests showed: WBC: 3.6 (low), RBC: 5.54 (high), Hemoglobin: 17.1 (high), Hematocrit: 49.9 (high), and
IGM 242 (high) with 'Kappa and lambda typing appearing increased.' The PE scan is pending. Sed rate is 1. Can you help me to
interpret these findings?
Prior to this, I had an appointment with The Cleveland Clinic in Ohio set for August 12 with their rheumatology/immunology
dept. and am wondering also if I am heading to the right department as I continue with the testing/diagnostic.
Answer by Dr Dennis S, MD on Wed 28, Jul 2010 07:07pm:
Do you also have the differential count of your cbc?
Your white blood cell count is lower than normal, which could mean that there is an ongoing infection. An empiric antibiotic therapy can be instituted after appropriate cultures are done.
Other causes of decrease in white blood cell count include intake of certain drugs like penicillins and steroids. Autoimmune disorders and hematologic disorders are also causes.
Aside from consulting a rheumatologist, you may also want to consult a hematologist and/or an infectious disease specialist for further evaluation.
Please rate my answer (select the stars, no need to log in.)
Clarification by miya on Thu 29, Jul 2010 05:42pm:
Yes, it appears to be a CBC w/differential. Would you like some of those numbers? I am taking no other drugs
(incidentally, am allergic to penicillins). Doctor said he wanted to do the PE/IFE to identify the reason
for the elevated protein and check for indication of Multiple Myeloma. The results state there was no M-spike
observed. However, Immunoglobulin M came back high, as I said. Immunofixation result showed an apparent
Polyclonal Gammopathy; IGM - Kappa lambda typing appear increased. No fever or unusual symptoms since last
batch of tests run a couple of months ago, however, the blood counts have changed from the normal results from
a couple months ago. I am experiencing pain and feeling of fullness that has been waking me up at night since
this batch of tests done last week. Perhaps spleen? He also ordered an MRI for an apparent complex partial
seizure he believes I had in his office (thought it was blood sugar, but came back normal when he tested it
there) which I haven't had performed as of yet. -- Hepatitis B/C antigens, Thyroid Peroxidase,
Thyroglobulin antibodies, Lyme, and ANA all came back negative. Rheumatoid factor, C-reactive tests done
prior to this (recently) were negative. Complete metabolic panel, T-Cell activation, CD-8 subsets, T + B
Lymphocyte diff., Helper T- Lymph CD-4 and Kappa Lambda free light chains were also tested. Any further
insights with this information? I assume they cross-evaluate their findings with other specialists outside
the rheumatology dept., but will request a hematologist and/or infectious disease specialist, if I find that
they do not. Thank you.
Clarification by miya on Thu 29, Jul 2010 05:47pm:
Sorry, I didn't specify where the pain was: just below my left ribs, left/mid side of abdomen, hence
This question is open for comments. Please share your opinion.
- Cancer? fever
and a pain on the left side of my body near my ovaries and a pain near my liver (Answered)
- Viewed 8917 times
Back in august I had an MRI, because of severe headaches, nausea, loss of feeling in myy right hand, and
fainting( dizzines too)...
- sclc metastasized to lymph nodes and
bones-stage IV (Answered)
- Viewed 2657 times
Which counts in your CBC blood work tell if the chemo is working? Her hemoglobin has been 9.8 9.2 8.1 8.2after
a transfusion it ...
- Cancer uteri after successful
radiotherapy of cervical cancer (Answered)
- Viewed 3254 times
Woman, 65 yo, with hystory of myoma uteri, diabetes and hypertension has been diagnosed with cervical cancer
- Multinodal cabcer uteri -
effective treatment of lymphostasis/edema (Answered)
- Viewed 3392 times
Woman, 65 yo, with history of myoma uteri, diabetes and hypertension has been diagnosed with cervical cancer
- hemoglobin D disease (Answered)
- Viewed 3177 times
i am a pediatric oncologist in iraq, i have a case of hemoglobin D diseas, i just want to know any thing about
this disease. th...
- Differential WBC counts..does it mean
- Viewed 4032 times
I Had a routine blood test done during physical exam in 2008 and there was a difference observed in WBC
differential counts. (Lo...
- female, 48, chronic cough, servere
- Viewed 2733 times
hello there, i have a question regarding my mum. she is 48, on no medications, never had any health problems
in her life. for...
- Melanoma metastasis (Answered)
- Viewed 2162 times
Dear doctor, My father (age 58, non-smoker, previous health condition excellent) was diagnosed with
metastatic malignant mela...
- Soft-tissue tumor in foot (Answered)
- Viewed 3126 times
I have a soft tissue tumor in my left foot, between the first and second metatarsal. It is inside of my foot,
just deep to the ...
- lymphoma (Answered)
- Viewed 2344 times
Bone marrow biopsy shows: (...a white count of 7.2 hemoglobin 12.2 MCV 86 platelet count 185 and approximate
differential of 50...