Case study of ASH A

Below is an evaluation of the provided lab test results, categorized by each parameter. The assessment results of standard reference ranges and potential clinical implications are assessed.

1. Protein Total: 7.6 g/dL

• Reference Range: 6.0–8.3 g/dL
• Interpretation: Normal. This indicates adequate protein levels in the blood, reflecting proper liver function and nutritional status.

2. Albumin: 4.6 g/dL

• Reference Range: 3.5–5.0 g/dL
• Interpretation: Normal. Albumin is a marker of liver function, nutritional status, and hydration. This value suggests no significant abnormalities.

3. Glucose: 99 mg/dL

• Reference Range (Fasting): 70–99 mg/dL
• Interpretation: Normal fasting glucose level, indicating no immediate signs of diabetes or impaired glucose regulation.

4. PSA (Prostate-Specific Antigen): 1.28 ng/mL

• Reference Range: <4.0 ng/mL (age-dependent)
• Interpretation: Normal. This suggests no immediate concerns for prostate abnormalities such as benign prostatic hyperplasia (BPH) or prostate cancer.

5. TSH (Thyroid-Stimulating Hormone): 3.91 µIU/mL

• Reference Range: 0.4–4.0 µIU/mL
• Interpretation: Borderline high-normal TSH level may indicate subclinical hypothyroidism or a need for closer monitoring of thyroid function, especially if symptoms like fatigue or weight gain are present.

6. RBC (Red Blood Cell Count): 5.81 M/µL

• Reference Range: 4.7–6.1 M/µL (male), 4.2–5.4 M/µL (female)
• Interpretation: Normal for males; slightly elevated for females, which could indicate dehydration or potential polycythemia if other parameters are abnormal.

7. MCH (Mean Corpuscular Hemoglobin): 26.5 pg

• Reference Range: 27–33 pg
• Interpretation: Slightly low, suggesting microcytic anemia, possibly due to iron deficiency or chronic disease.

8. MCHC (Mean Corpuscular Hemoglobin Concentration): 32.0 g/dL

• Reference Range: 31–37 g/dL
• Interpretation: Normal, indicating no significant issues with hemoglobin concentration in red blood cells.

9. MPV (Mean Platelet Volume): 11 fL

• Reference Range: 7–11 fL
• Interpretation: High-normal, which could indicate increased platelet production or activation, often seen in inflammation or certain blood disorders.

10. Absolute Monocyte Count: 0.65 K/µL

• Reference Range: 0.2–0.8 K/µL
• Interpretation: Normal, suggesting no immediate infection or chronic inflammation concerns.

11. Monocyte Percentage: 8%

• Reference Range: 2–10%
• Interpretation: Normal percentage within the differential white blood cell count.

12. Urinalysis Results

a) Blood, UA: Trace (Abnormal)

• Indicates the presence of trace amounts of blood in the urine, which may suggest mild trauma, infection, kidney stones, or other renal issues.

b) Urobilinogen: 0.2 E.U./dL

• Reference Range: <1 E.U./dL
• Interpretation: Normal.

c) RBC in Urine: 2–5/hpf (Abnormal)

• Indicates microscopic hematuria, which may point to urinary tract infections (UTIs), kidney stones, or other renal pathology.

Summary of Findings:

Most parameters fall within normal limits; however:

1. Slightly low MCH suggests a potential for microcytic anemia.
2. Borderline high TSH warrants monitoring for thyroid dysfunction.
3. Trace blood and RBCs in urine require further investigation to rule out underlying renal or urinary tract issues.

If symptoms are present or persist over time, follow-up with a healthcare provider is recommended for further evaluation of abnormal urinalysis findings and thyroid function.

References

1. Laboratory Reference. (n.d.). Webpath.med.utah.edu. https://webpath.med.utah.edu/EXAM/LABREF.html

2. Laboratory Reference. (n.d.). Webpath.med.utah.edu. https://webpath.med.utah.edu/EXAM/LABREF.html 

3. Laboratory Reference. (n.d.). Webpath.med.utah.edu. https://webpath.med.utah.edu/EXAM/LABREF.html 

4. UCSF Health. (2019, January 26). Albumin Serum. Ucsfhealth.org. https://www.ucsfhealth.org/medical-tests/albumin-blood-(serum)-test 

5. 001081: Albumin. (n.d.). Labcorp. https://www.labcorp.com/tests/001081/albumin 

6. Devaraj, S. (2019, November 9). Albumin: Reference Range, Interpretation, Collection and Panels. Medscape.com. https://emedicine.medscape.com/article/2054430-overview 

7. Cleveland Clinic. (2022). Albumin Blood Test: What It Is, Purpose, Procedure & Results. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22390-albumin-blood-test 

8. Albumin (Blood). (2024). Rochester.edu. https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=167&contentid=albumin_blood