Systemic Lupus Erythematosus
Test Results
| Component | Mrs. Evan's Results | Normal Range * |
|---|---|---|
| Red blood cells (RBC) | 4.0 million/mm3 | Female 4.2 - 5.4 million/mm3
Male 4.7 - 6.1 million/mm3 |
| White blood cells (WBC) | 3,950/mm3 | 5,000 - 10,000/mm3 |
| Hemoglobin (Hgb) | 11 g/dl | Female 12 - 16 g/dl
Male 14 - 18 g/dl |
| Hematocrit (Hct) | 36% | Female 37 - 47%
Male 42 - 52% |
| Platelet count | 148,700/mm3 | 150,000 - 400,000/mm3 |
| Mean corpuscular volume (MCV) | 86 µm | 80-95 µm |
| Mean corpuscular hemoglobin (MCH) | 28 pg | 27-31 pg |
| Mean corpuscular hemoglobin concentration (MCHC) | 33 g/dl | 32 - 36 g/dl |
| Neutrophils | 62% | 55 - 70% |
| Lymphocytes | 28% | 20 - 40% |
| Monocytes | 7% | 2 - 8% |
| Eosinophils | 2% | 1 - 4% |
| Basophils | 1% | 0.5 - 1.0% |
* Normal ranges may vary among different references. These normal ranges given are for adults.
| Component | Mrs. Evan's Results | Normal Range * |
|---|---|---|
| Alkaline phosphatase | 25 U/ml | 13 - 39 U/ml |
| Asparate amino transferase (AST) | 28 U/ml | 5 - 40 U/ml |
| Alanine amino transferase (ALT) | 22 U/ml | Female 5 - 35 U/ml |
| Blood urea nitrogen (BUN) | 25.5 mg/dl | 8.0 - 25.0 mg/dl |
| Creatinine | 1.8 mg/dl | 0.7 - 1.5 mg/dl |
| Sodium (Na) | 138 mEq/L | 137 - 147 mEq/L |
| Chloride (Cl) | 104 mEq/L | 100 - 106 mEq/L |
| Potassium (K) | 4.2 mEq/L | 3.5 - 5 mEq/L |
| Carbon dioxide (CO2) | 25 mEq/L | 24 - 29 mEq/L |
| Calcium (Ca) | 8.7 mg/dl | 8.5 - 10.3 mg/dl |
| Phosphate | 3.9 mg/dl | 3 - 4.5 mg/dl |
| Uric acid | 3.1 mg/dl | 2.6 - 7.2 mg/dl |
| pH | 7.42 | 7.35 - 7.45 |
* Normal ranges may vary among different references. These normal ranges given are for adults.
| Component | Mrs. Evan's Results | Normal Range * |
|---|---|---|
| Triiodothyronine (T3) | 167 ng/dl | 110 - 230 ng/dl |
| Thyroxine (T4) | 6 µg/dl | 4 - 11 µg/dl |
| Thyroid stimulating hormone (TSH) | 8 µU/ml | 2 - 10 µU/ml |
* Normal ranges may vary among different references. These normal ranges given are for adults.
Erythrocyte sedimentation rate (ESR) measures in millimeters
how fast red blood cells cling together, fall and settle in the bottom of the
glass tube over one hour. This test is nonspecific and is used to detect
inflammatory, neoplastic, infectious, and necrotic processes.
For inflammation, the higher the rate, the greater the amount of inflammation.
The normal range for ESR:
Male: up to 15 mm/hr.
Female: up to 20 mm/hr.
Mrs. Evan's results: 240 mm/hr.
| Component | Mrs. Evan's Results | Normal Range * |
|---|---|---|
| Color | Amber | Yellow - amber |
| Turbidity | Clear | Clear to slightly hazy |
| Specific gravity | 1.018 | 1.010 - 1.025 |
| pH | 5.0 | 4.6 - 4.8 |
| Glucose | Negative | Negative |
| Ketones | Negative | Negative |
| Blood | Negative | Negative |
| Protein | Trace | Negative |
| Bilirubin | Negative | Negative |
| Urobilinogen | 0.5 | 0.1 - 1.0 |
| Nitrate for bacteria | Negative | Negative |
| Leukocyte esterase | Negative | Negative |
| Casts | Occasional hyaline casts | Negative to occasional hyaline casts |
| RBCs | Occasional | Negative or rare |
| Crystals | Negative | Negative |
| WBCs | Rare | Negative or rare |
| Epithelial cells | Few | Few |
* Normal ranges may vary among different references. These normal ranges given are for adults.
X-rays: Hands, wrists and knees showed soft tissue swelling and no joint space narrowing or bone damage.
Interpretation of Lab Values, History and Physical Exam
At this point, given her symptoms of arthralgia, extreme fatigue, decreased appetite, joint swelling and stiffness, and difficulty sleeping, the test results suggest a rheumatic disease. The physical findings of joint stiffness and swelling in her hands and wrists, and swelling and decreased ROM in her right knee also support this conclusion. In addition, the high ESR and slightly high kidney function indicated by the BUN, creatinine and trace of protein in the urine also suggest the possibility of a rheumatic disease. Given these results, it is likely the rheumatologist will order further tests.
School of Health Professions
University of Missouri-Columbia
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Last Update: Aug 29 2006