Lab results what do they mean?

Question

My daughter was 6yrs old and has had too many lab work ups. Military dr.'s don't tell you anything. They just pass you on to the next duty station. Her lymph node in her throat has been swollen off and on - larger than a grape, since she was a baby. They don't look at her past lab results or medical history and work-ups. Can someone tell me what these labs mean?
IGG 1163
IGA 151
IGM 56
Hemolysis Index 2
Icteric index 0
Lipemia index 8
WBC SMRKR 5.7
%Lymphs 52.1 H
Lymph # 3
CD45 & CD14 0.6
CD3/T3 & CD8/T8 30.1
CD3 73.9
CD8/T8 Suprss 32.5
CD3 & CD4 33.7
CD4/T4 helper 34.3
CD3- & CD19 14.9
CD3- & CD56 8.2
CD56/NKH-1 LGL 9.9
ABC CD3/CD8 903.0 H
T SUM 50.4
LYMPH SUM 99.3
CD4/(CD8 & CD3) 1.12
ABS CD4 10.11
LYMPH ATYP/100 WBC 1 H
CMV IGG NEG
CMV IGM NEG
ANA SCREEN POSITIVE H
ANA TITER 1:80+ H
ANA PATTERN SPECKLED H
DNA DS AB <1:10 NEG
DNASE B AB <1:60 NEG
ASO 125

First off, military uses the same labs. 2nd, I have looked up the results on the web, but doesn't really tell me much, she has autoimmune disease/disorder. Do you know how hard it is to get copies of lab results? Its a nightmare, and no one tells you anything. My daughter is now 10yrs old and for the past many years she has so many episodes that military doctors don't know whats wrong with her, nor will they do anymore testing on her. It took 3yrs of fighting to get them to approve a biopsy on her neck/lymph node, but then they cancelled it, it was no longer swollen. She has been complaining of severe headaches, burning eyes, severe ear aches, almost every 3-6mo I need to buy stronger prescription lenses. Since 2wk of age she would get high fevers up to 108 degrees. Doctors said she has Lupus, then she doesn't have it, now the dr.'s here say she has Rheumatiod Arthritis, her joints don't hurt. They hurt when she has fever. She hasn't had fever for 1yr only gets the symptoms.

The RF was negative many times, she has seen over 50 Rheumatology doctors and told her she doesn't have R.A. but a military dr. took x-rays of her and sent them to Tripler AMC, Hawaii and they said she has arthritis. Since then I refuse to take her to the doctors here. They won't give me a referal to ENT, so she complains of the pain in the ear all the time. There are times where you can be talking to her and then she is gone, she dropped to the floor squating putting her head between her knees crying her head hurts, her eyes burning, she will be freezing and shivering, she use to spike a high fever right away, but doesn't get the fevers anymore just the symptoms. Here fevers strike out of the blue, she can be playing and then be at 108 degrees and wiped out.

Her tonsils were taken out in 2003 and her hair finally grew before it never grew. It grew 9" in less than 6mo. We currently live in Japan, we can only see Navy doctors currently. We won't be back in the states until 2010. And they won't give her a referal for ENT or any specialists in Hawaii.

Answer 1

I'll give her a go. It is kind of hard interpreting labs online like this, without the paper in front of you with the units and the ranges, you could easily miss something that woul otherwise be obvious. I won't ask you to try and reproduce it exactly, it would be too much work. Also, any advice you get online should be taken with a grain of salt, if you didn't already know that. With that out of the way, here goes.
I'm guessing that where there is an H, it means the values were high. They did a detailed workup of the white blood cells, likely to rule out any lymphoma or leukemia because of the swollen glands. While it could be a possibility, there is a more likely explanation. Going with that, the lymphocytes were high, likely indicating a viral or intracellular infection. The high cd3/cd8 count backs that up. cd3 and cd8 cells are the ones that are responsible with killig your own cells once they become infected, typically with viral infections. Looks like after that they ran a CMV titer to see if that was the cause. There was probably a specific reason they ran a cytomegalovirus(CMV) IG titer, but without the entire medical record, no way to know for sure, but that was negative.
After that, they ran the ANA and anti dsDNA antibody tests. ANA is antinuclear antibodies, anti dsDNA is antibodies that attack our double stranded DNA. Both are typically present in lupus. Most people with lupus have a positive ANA, which your child has. However, a positive does not mean lupus. You need to do ther tests, like the anti dsDNA to know for sure. Since your child was negative for that, it is unlikely it is Lupus. Also, the pattern was speckled, which could mean that it could be many other connective tissue disorders. Like you have already been told, the tests so far lean towards rheumatoid arthritis. I don't know the history or physical for your child, so I can't comment on that.
I know you have already seen some docs, but for simplicity, I'm gonna pretend you have only seen one so far. In order to know rheumatoid for sure, you need to have a rheumatoid factor blood test done. If it is positive, you can be pretty sure that it what the problem is. I recommend finding a rheumtologist if possible. I know the military will likely not have many, and if you do find one, it will likely be a long wait. I would definitely recommend a civilian doc if at all possible, I don't know what your insurance allows you to do.
Good luck, keep hammering the docs for this, any respectable doctor that saw a kid like this should be bending over backwards to figure out what it is. Keep on them, and while it might take a while, you will figure out what this is, and a way to treat it and make it at least manageable. I'd be glad to offer more advice if you'd like.

Answer 2

First of all, I'm incredulous that your doctor or parents didn't help you interpret the results (contrary to popular belief, anybody can obtain a copy of their own or child's medical records, including blood tests; most doctors' offices will give you a copy upon request at no charge). Second, you omitted many other details that may be important, including sugar levels (diabetes), cholesterol (heart and blood problems), white and red blood cell counts, etc. Third, regardless of the above, your given numbers indicate an overall anemia. With your doctor's permission, you should take a multi-vitamin with iron, and start regular, light exercise to build up your cardiovascular system, to improve blood flow and help get rid of toxins. If you haven't been eating right, now is the time to get off the supermodel or junkfood diet, and eat like a regular person. If you are into cigarettes, alcohol, or other drugs - - legal or otherwise (definitely *not* at your age) - - , stop it, NOW. Iron supplements, alone, are of little value if you are doing everything else wrong! Fourth, only a fool would take the advice of a stranger over that of their doctor, but it is a very clever fool, indeed, to list just enough information to make us think something is terribly wrong. Even if this was a backhanded approach at getting us to answer your medical homework, all I can say is, "Nice try, kiddo!"

Answer 3

I am not a doctor, but I could easily look up what all of those results are testing for. You have already stated part of the problem. You are going to different doctors. First of all, it sounds like you are asking for copies of the test on the spot. Excellent! There are many different labs analyzing the blood work, and what is normal for one lab may be 'out of range' for another, partly in due to their handling protocol.This can be very confusing to practitioner and layman alike. The tests you have need to be taken to a doctor that may order more tests, but you are in the same puddle unless that doctor can see you again. This way you know that she or he is using the same lab,and can compare the results side by side. I hope this helps. Gerald

Answer 4

Well it seems that your child has a long history of recurrent laryngitis/pharingytis probably due to streptococci. The problem is that over such a long time this disease affects her heart valves and causes ...rheumatoid arthritis. (Nothing to do with joints) Cant you go to a civilian doc or clinic and 1) have a biopsy performed on that swollen node (swollen or not 2) do a throat exsudate and once and for all determine the bug causing the problem 3) if she still has her tonsils chances are that she will need a tonsillectomy and lastly 4) go to a civilian cardiologist , have an ECG performed and have him determine whether she has an heart murmur or another deficiency. I wish you the best of luck.