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January 26, 2015 | 80,00 EUR | answered by Dr. med. Ralf Berg
Hello.
Can you tell me if you can interpret anything from the following lab values? If yes, what diseases would you suspect?
It is certain: insulin resistance, thyroid dysfunction.
- S-measles IgG elevated (841 IU/l)
- S-rubella IgG elevated (148 IU/ml)
- Rubella ASI IgG elevated (2.14 index)
- S-VZV IgG elevated (3630 IU/l)
- VZV ASI IgG elevated (2.04 index)
- CRP elevated and fluctuating significantly for years (up to 20 mg/l)
- Cerebrospinal fluid - nucleated cells elevated (13)
- Cerebrospinal fluid - lactate decreased
- Cerebrospinal fluid - oligoclonal IgG bands present
- Alpha1 elevated
- Alpha2 elevated
- MCHC decreased
- HCT elevated
- Rheumatoid factor elevated
- Lactate dehydrogenase elevated
- MCV decreased (83 fl)
- GPT elevated (51 U/l)
- Triglycerides elevated (209 mg/dl)
- Parathyroid hormone elevated (8.10 pmol/l)
- Vitamin D severely decreased
- CCP elevated (2.1 U/ml)
- FT4 elevated (19.20 ng/ml)
- Parvo-B19 IgG antibodies positive
The following symptoms are present that do not fit with the above diagnoses:
- severe weakness,
- fatigue,
- lack of concentration,
- severe pain in arms, legs, chest, and back...
there are a few other symptoms, but the ones mentioned above are the worst.
What could it be? Autoimmune diseases?
MS has been ruled out due to the absence of lesions (so far).
We have been going from specialist to specialist for years... each had ideas, but none have proven true so far. (This is not a criticism of the doctors)
Thank you for a few non-binding suggestions and ideas. I would appreciate some clear words.
I am aware that EVERYTHING must go through the treating general practitioner (or specialists). I know that online remote diagnoses are generally not good. However, I am only looking for ideas to bring to my doctor - he is open to such things.
Thank you.
Good evening,
I will try to add comments in order:
The first five parameters are immunoglobulin titers and indicate that they have antibodies against measles, rubella, and chickenpox (VZV Varicella Zoster Virus), either through vaccination or infection.
If CRP is always elevated, there may be a chronic inflammatory disease in the body. This could be related to the rheumatic area (elevated rheumatoid factor and CCP).
The cerebrospinal fluid findings are nonspecific except for the slightly elevated cell counts. This does not suggest MS or a degenerative systemic disease.
Low MCV and MCHC levels may indicate a B-vitamin deficiency, while high hematocrit suggests the need for more hydration.
LDH, GPT, and triglycerides are slightly elevated, but not enough to detect a disease.
Parathormone levels may indicate mild hyperparathyroidism, while high FT4 levels do not match the symptoms of fatigue, weakness, etc.
You should take vitamin D.
Lastly, you have had an infection with parvoviruses in the past. What could all these symptoms indicate?
It is likely that the diagnoses of RF = Rheumatoid Arthritis have already been considered, as well as the presence of fibromyalgia or various forms of connective tissue diseases (collagenoses) based on your symptoms.
Regarding the thyroid, more parameters (TSH, FT3) should be tested to determine if there is over/underfunction. Specific antibodies against thyroid tissue that can trigger autoimmune thyroiditis (e.g., Hashimoto's or de Quervain's) should also be tested. I assume this has already been done.
In conclusion, I suggest considering Mixed Connective Tissue Syndrome, also known as Sharp Syndrome. This is the name for a collagenosis that has not yet determined what it wants to become when it grows up. I recommend discussing this with a doctor specializing in collagenoses. If I had to make a decision, I would most likely consider autoimmune thyroiditis as a possibility.
Best regards, R. Berg
