7 p.m.

This late breaking email from Dr. Damon is encouraging!

Enjoy!

Dave
_____________________________

Dave,
Below are Irene’s lab tests – nothing remarkable. The free light ratio remains normal, so she continues to be in complete remission of amyloid!!

The labs do not explain her anemia beyond renal failure. The TSH is a bit high, and might suggest a low thyroid function (which can cause anemia), but her T4 is normal, ruling out a low thyroid function. Her ferritin is high, seen in renal failure, and high enough to rule out iron deficiency. The retic count was a bit high, reflecting young red blood cells made by the bone marrow in response to her epo dose the day before. In sum, this lab work does not explain her anemia, except for the renal failure. If the anemia continues to be an issue, then we’ll need to do a bone marrow biopsy – time will tell. L. Damon, MD

DIAS, IRENE                           USER:Damon
=====================================================================
*=abnormal   l*=low   h*=high   L*=panic low   H*=panic high   #=normal unknown
SITE   DATE   TIME LABORATORY         RESULTS   UNITS   NORMAL   ACRO
=====================================================================
PARN 3-15-12 12:11 DIRECT COOMBS TEST                         DRCT
DIR. ANTIGLOBULIN TEST   NEG                 %DBS
09:52 UNACCEPTABLE SPECIMEN                       USPE
BLOOD BANK                             UBBS
Patient info on requisition missing, incorrect or
illegible
DIRECT ANTI HUMAN GLOGULIN TEST (DCT)
Unit or MD notified
PAULA ACC TX AT 3 2252/RJT
08:30 CBC WITH/DIFF & PLT CT
WBC COUNT           5.1   x10E9/L 3.4-10   WBC
RBC COUNT         l*2.90   x10E12/L 4.0-5.2   RBC
HEMOGLOBIN         l*10.1   g/dL   12.0-15.5 HGB
HEMATOCRIT         l*29.8   PERCENT 36-46     HCT
MCV             h*103   fL     80-100   MCV
MCH             h*34.7   pg     26-34     MCH
MCHC               33.8   g/dL   31-36     MCHC
(Q=Quit, =Continue, P=Patient, C=Copy to ptr, ?=Help,
ARN 3-15-12 08:30   PLATELETS           169   x10E9/L 140-450   PLT
NEUTS             2.99   x10E9/L 1.8-6.8   N-A
LYMPHS             1.64   x10E9/L 1.0-3.4   L-A
MONOS             0.35   x10E9/L 0.2-0.8   M-A
EOS               0.12   x10E9/L 0.0-0.4   E-A
BASOS             0.03   x10E9/L 0.0-0.1   B-A
RETIC CT BY FLOW CYT   h*109.8   x10E9/L 21-80     RETF
ELECTROLYTE PANEL
SODIUM, SERUM         144   mmol/L   135-145   NA
POTASSIUM, SERUM       4.0   mmol/L   3.8-5.1   K
CHLORIDE           100   mmol/L   97-108   CL
CARBON DIOXIDE, TOTAL   30     mmol/L   22-32     CO2
ANION GAP           14           4-14     ANGA
Anion gap is calculated as Na-(Cl+CO2)
UREA NITROGEN         h*37     mg/dL   6-22     BUN
AST                 19     U/L     17-42     AST
ALT                 24     U/L     11-50     ALT
PARN 3-15-12 08:30 BILIRUBIN TOTAL         0.5   mg/dL   0.2-1.3   BILT
ALKALINE PHOSPHATASE   h*152   U/L     31-95     ALKP
PROT ELECTROPHORESIS                 XXXX     PE
Normal pattern
PROTEIN, TOTAL       7.1   g/dL   6.0-8.1   TP
ALBUMIN (PART OF PE)    4.6   g/dL   3.1-5.4   ALBL
ALPHA-1 GLOBULIN       0.1   g/dL   0.1-0.3   A1G
ALPHA-2 GLOBULIN       0.8   g/dL   0.4-1.2   A2G
BETA GLOBULIN         0.8   g/dL   0.6-1.2   BGL
GAMMA GLOBULIN       0.8   g/dL   0.6-1.6   GG
Interpreted by: Theodore W. Kurtz M.D.
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
PARN 3-15-12 08:30 IMMUNOFIXATION, SERUM               XXXX     IFE
No paraproteins present
Interpreted by: Theodore W. Kurtz M.D.
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
IGG                 1040   mg/dL   672-1760   IGG
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
IGM                 68     mg/dL   39-333   IGM
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
IGA                 163   mg/dL   89-581   IGA
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
PARN 3-15-12 08:30 TSH(THYROTROPHIN)      h*6.48   mIU/L   0.40-4.00 TSH
ADD 3/15 @9:12 PER JEN 38167
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
FERRITIN           h*994   ug/L   10-291   FERR
ADD 3/15 @9:12 PER JEN 38167
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
CREAT WITH eGFR
CREATININE         h*5.90   mg/dL   0.52-1.06 CR
eGFR IF CAUCASIAN     l*7     mL/min   >60     GFRC
eGFR IF AFRICAN AMER   l*9     mL/min   >60     GFRA
eGFR corrected for 1.73 sq meters body surface area
NOTE: eGFR is only an estimation. Please see on-line
Lab Manual for potential limitations
PARN 3-15-12 08:30 FREE T4             11     pmol/L   9-24     FT4
ADD 3/15 @9:12 PER JEN 38167
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
VITAMIN B12           432   ng/L   211-911   VB12
Request added on
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
FOLATE, RBC         h*1254   ug/L RBC 280-791   RFOL
ADD 3/15 @9:12 PER JEN 38167
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
CHOL, TRIG, HDL, & LDL
CHOLESTEROL, TOTAL     184   mg/dL   Desirable
TRIGLYCERIDES h*230 mg/dL Suggests high cardiovascular risk
PARN 3-15-12 08:30 HDL CHOLESTEROL 49 mg/dL >39     HDL
Acceptable
CHOL HDL RATIO       3.8                       NON HDL CHOLESTEROL     135   mg/dL                   Near or above optimal
LDL CHOLESTEROL       89     mg/dL                   Optimal
K/L LT CHAINS,FREE
KAPPA/LAMBDA RATIO     0.93         0.26-1.65 KLR
Perfrm’d at UCSF China Basin Lab, 185 Berry, San
Francisco, CA 94107
KAPPA LT CHAIN,FREE   h*66.0   mg/L   3.3-19.4   KAPF
LAMBDA LT CHAIN,FREE   h*71.1   mg/L   5.7-26.3   LAMF